HODA H MAZLOUM Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085006453

License Status

NOT RENEWED

Business

First Name

HODA

Middle

Last Name

MAZLOUM

Business Name

HODA H MAZLOUM

Original Issue Date

11/16/2017

Effective Date

03/02/2018

Expiration Date

03/01/2020

City

CHICAGO

State

Zip

60616

County

COOK

Ever Disciplined

LastModifiedDate

11/24/2020