NIDA SHADAI FAYZI HUSAIN DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****55

License Status

NOT RENEWED

Business

Title

First Name

NIDA

Middle

SHADAI FAYZI

Last Name

HUSAIN

Business Name

NIDA SHADAI FAYZI HUSAIN DO

Original Issue Date

01/02/2020

Effective Date

01/02/2020

Expiration Date

09/30/2020

City

CANTON

State

Zip

48188

County

WAYNE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021