GHAZALA FARAH RAHMAN 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

First Name

GHAZALA

Middle

FARAH

Last Name

RAHMAN

Suffix

Business Name

GHAZALA FARAH RAHMAN MD

Original Issue Date

01/10/2006

Effective Date

06/20/2012

Expiration Date

07/31/2014

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017