JORDAN KAZAKOV MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

NOT RENEWED

Business

Title

First Name

JORDAN

Last Name

KAZAKOV

Business Name

JORDAN KAZAKOV MD

Original Issue Date

03/23/2019

Effective Date

03/23/2019

Expiration Date

09/30/2020

City

BROOKLYN

State

Zip

11201

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021