SYED FAHAD IMAM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****91

License Status

ACTIVE

Business

Title

First Name

SYED

Middle

FAHAD

Last Name

IMAM

Business Name

SYED FAHAD IMAM MD

Original Issue Date

04/03/2017

Effective Date

04/24/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61603

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/24/2023