MARYAM REZVANI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036115412

License Status

NOT RENEWED

Business

First Name

MARYAM

Last Name

REZVANI

Suffix

Business Name

MARYAM REZVANI MD

Original Issue Date

03/14/2006

Effective Date

04/12/2017

Expiration Date

09/30/2020

City

SALT LAKE CITY

State

Zip

84108

County

UTAH

Ever Disciplined

LastModifiedDate

01/14/2021