ISSA POUR-GHAZ MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****97

License Status

ACTIVE

Business

Title

First Name

ISSA

Last Name

POUR-GHAZ

Business Name

ISSA POUR-GHAZ MD

Original Issue Date

03/15/2023

Effective Date

04/09/2023

Expiration Date

07/31/2026

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/10/2023