JALAL FATEMI-BOUSHEHRI Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036046620

License Status

NOT RENEWED

Business

First Name

JALAL

Last Name

FATEMI-BOUSHEHRI

Business Name

JALAL FATEMI-BOUSHEHRI

Original Issue Date

11/16/1972

Effective Date

11/16/1972

City

BRIDGETON

State

Zip

63044

County

MISSOURI

Ever Disciplined

LastModifiedDate

09/20/2006