AFTAB A ANSARI MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125006132

License Status

EXPIRED

Business

First Name

AFTAB A

Last Name

ANSARI

Suffix

Business Name

AFTAB A ANSARI MD

Original Issue Date

05/05/2010

Effective Date

05/05/2010

Expiration Date

09/23/1974

City

KENOSHA

State

Zip

53144

County

WISCONSIN

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

05/05/2010