FIRDAUSI F MAZDA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

NOT RENEWED

Business

First Name

FIRDAUSI F

Last Name

MAZDA

Suffix

Business Name

FIRDAUSI F MAZDA MD

Original Issue Date

07/23/1990

Effective Date

07/23/1990

Expiration Date

07/31/1999

City

ELK GROVE VILLAGE

State

Zip

60007

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020