AUDREY KATHRYN FOTOUHI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****46

License Status

ACTIVE

Business

Title

First Name

AUDREY

Middle

KATHRYN

Last Name

FOTOUHI

Business Name

AUDREY KATHRYN FOTOUHI MD

Original Issue Date

05/30/2024

Effective Date

05/30/2024

Expiration Date

07/31/2026

City

BLOOMFIELD HILLS

State

Zip

48302

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/30/2024