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Licensing details for: PTL 8092

Name: Fozouni, Laila

License Type: Postgraduate Training License

Primary Status: License Canceled Primary Status Definition

School Name: University of California San Francisco School of Medicine

Graduation Year: 2021

Current Enrolled Postgraduate Training Program

Facility Name: UNIVERSITY OF CALIFORNIA (SAN FRANCISCO) PROGRAM

City: San Francisco

State: California

Speciality: Internal Medicine

Start Date: 06/21/2021

Anticipated End Date: 06/28/2024

Address of Record

505 Parnassus Ave
SAN FRANCISCO CA 94143-2204
SAN FRANCISCO county
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Issuance Date

November 9, 2021

Expiration Date

N/A

Current Date / Time

April 3, 2026
2:11:01 AM

Public Record Actions

Public Documents

License Relationships

Postgraduate Training License associated with Physician & Surgeon License

License/Registration Role: Postgraduate Training License

Related Party Role: Physician & Surgeon

Name: Fozouni, Laila

License/Registration Type: Physician's and Surgeon's

License Number: 191580 Primary Status: Delinquent - License renewal fee has not been paid. No practice is permitted.

Address :
505 Parnassus Ave # M1480
SAN FRANCISCO CA 94143-2204
SAN FRANCISCO COUNTY

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Postgraduate Training License associated with Physician & Surgeon License

License/Registration Role: Postgraduate Training License

Related Party Role: Physician & Surgeon

Name: MALIK, ANEEQ IBRAHIM

License/Registration Type: Physician's and Surgeon's

License Number: 192471 Primary Status: License Renewed & Current

Address :
7096 Olive Grove St
RIVERSIDE CA 92507-1495
RIVERSIDE COUNTY

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