KHALID A AZZAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

NOT RENEWED

Business

Title

First Name

KHALID

Middle

Last Name

AZZAM

Business Name

KHALID A AZZAM MD

Original Issue Date

04/10/2014

Effective Date

04/10/2014

Expiration Date

07/31/2017

City

SAINT PAUL

State

Zip

55125

County

MINNESOTA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017