BASSAM SOUFAN MD LTD Medical Corporation License verification

Business Entity

NOT RENEWED

License Type

Medical Corporation

Description

REGISTERED MEDICAL CORPORATION

License Number

042617002

License Status

NOT RENEWED

Business

Business Name

BASSAM SOUFAN MD LTD

Original Issue Date

11/23/1999

Effective Date

11/23/1999

Expiration Date

01/01/2002

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

09/26/2006