HOUMAN HORMOZDIAR KHOSROVI 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

HOUMAN

Middle

HORMOZDIAR

Last Name

KHOSROVI

Business Name

HOUMAN HORMOZDIAR KHOSROVI

Original Issue Date

08/21/1998

Effective Date

08/21/1998

Expiration Date

07/31/1999

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006