BAZAL EHSAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****59

License Status

ACTIVE

Business

Title

First Name

BAZAL

Last Name

EHSAN

Business Name

BAZAL EHSAN MD

Original Issue Date

04/22/2021

Effective Date

04/20/2023

Expiration Date

07/31/2026

City

ROANOKE

State

Zip

24018

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/20/2023