EBRAHIM MOSTOUFI-MOAB
Physician/surgeon


Address: 7380 Sandlake Rd, Orlando, FL 32819

EBRAHIM MOSTOUFI-MOAB (Credential# 546407) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is October 31, 1994. The license expiration date date is October 31, 1995. The license status is INACTIVE.

Business Overview

EBRAHIM MOSTOUFI-MOAB is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.027162. The credential type is physician/surgeon. The effective date is October 31, 1994. The expiration date is October 31, 1995. The business address is 7380 Sandlake Rd, Orlando, FL 32819. The current status is inactive.

Basic Information

Licensee Name EBRAHIM MOSTOUFI-MOAB
Credential ID 546407
Credential Number 1.027162
Credential Type Physician/Surgeon
Business Address 7380 Sandlake Rd
Orlando
FL 32819
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1986-04-09
Effective Date 1994-10-31
Expiration Date 1995-10-31
Refresh Date 2009-07-08

Office Location

Street Address 7380 SANDLAKE RD
City ORLANDO
State FL
Zip Code 32819

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City ORLANDO
Zip Code 32819
License Type Physician/Surgeon
License Type + County Physician/Surgeon + ORLANDO

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Dataset Information

Data Provider Connecticut Department of Consumer Protection
Jurisdiction Connecticut
Related Datasets Connecticut Business Registrations, Connecticut Child Care Facilities

This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).

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