SYED M SHAN-UL ISLAM MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036129382

License Status

INACTIVE

Business

Title

First Name

SYED M

Middle

SHAN-UL

Last Name

ISLAM

Business Name

SYED M SHAN-UL ISLAM MD

Original Issue Date

12/20/2011

Effective Date

07/24/2017

Expiration Date

09/30/2020

City

VALPARAISO

State

Zip

46385

County

INDIANA

Ever Disciplined

LastModifiedDate

04/05/2020