DANI TAZBAZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****69

License Status

NOT RENEWED

Business

Title

First Name

DANI

Last Name

TAZBAZ

Business Name

DANI TAZBAZ MD

Original Issue Date

01/11/2007

Effective Date

07/13/2017

Expiration Date

09/30/2020

City

RICHMOND HEIGHTS

State

Zip

63117

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021