OMAR EZZIDDIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036131711

License Status

NOT RENEWED

Business

Title

First Name

OMAR

Last Name

EZZIDDIN

Business Name

OMAR EZZIDDIN MD

Original Issue Date

11/09/2012

Effective Date

11/09/2012

Expiration Date

07/31/2014

City

NEW YORK

State

Zip

10128

County

NEW YORK

Ever Disciplined

LastModifiedDate

11/17/2014