ALI MAHDAVI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

NOT RENEWED

Business

Title

First Name

ALI

Last Name

MAHDAVI

Business Name

ALI MAHDAVI MD

Original Issue Date

06/23/2016

Effective Date

07/14/2017

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021