HESHAM M ELGHANNAM - Medical Doctor License in Wisconsin | # 036111514

HESHAM M ELGHANNAM

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036111514

License Status

NOT RENEWED

Business

N

First Name

HESHAM

Middle

M

Last Name

ELGHANNAM

Business Name

HESHAM M ELGHANNAM

Original Issue Date

06/01/2004

Effective Date

11/30/2017

Expiration Date

09/30/2020

State

WI

Ever Disciplined

N

LastModifiedDate

01/14/2021