VAJEEHA TABASSUM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****90

License Status

NOT RENEWED

Business

Title

First Name

VAJEEHA

Last Name

TABASSUM

Business Name

VAJEEHA TABASSUM MD

Original Issue Date

08/31/2010

Effective Date

06/17/2011

Expiration Date

07/31/2014

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014