BRIAN SOHEIL SHAFA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036143629

License Status

NOT RENEWED

Business

Title

First Name

BRIAN

Middle

SOHEIL

Last Name

SHAFA

Business Name

BRIAN SOHEIL SHAFA MD

Original Issue Date

06/22/2017

Effective Date

06/22/2017

Expiration Date

09/30/2020

City

PLEASANT RIDGE

State

Zip

48069

Ever Disciplined

LastModifiedDate

01/14/2021