KIAN ALI MODANLOU MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036111036

License Status

NOT RENEWED

Business

First Name

KIAN

Middle

ALI

Last Name

MODANLOU

Suffix

Business Name

KIAN ALI MODANLOU MD

Original Issue Date

03/18/2004

Effective Date

08/04/2008

Expiration Date

07/31/2011

City

MEMPHIS

State

Zip

38104

Ever Disciplined

LastModifiedDate

11/14/2011