ALIREZA IZADARA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

NOT RENEWED

Business

First Name

ALIREZA

Last Name

IZADARA

Suffix

Business Name

ALIREZA IZADARA MD

Original Issue Date

01/01/1997

Expiration Date

09/01/1982

City

CHEYENNE

State

Zip

82001

County

WYOMING

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020