ABOLFAZL SADAT-MANSOURI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****88

License Status

NOT RENEWED

Business

First Name

ABOLFAZL

Last Name

SADAT-MANSOURI

Suffix

Business Name

ABOLFAZL SADAT-MANSOURI MD

Original Issue Date

12/07/1990

Effective Date

12/07/1990

Expiration Date

07/31/1993

City

ELGIN

State

Zip

60123

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006