AHMED ALI TARIQ DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

ACTIVE

Business

Title

First Name

AHMED

Middle

ALI

Last Name

TARIQ

Business Name

AHMED ALI TARIQ DO

Original Issue Date

04/12/2004

Effective Date

05/03/2023

Expiration Date

07/31/2026

City

MAKANDA

State

Zip

62958

County

JACKSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/03/2023