JACOB JOSEPH MUSALLAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036051036

License Status

NOT RENEWED

Business

First Name

JACOB JOSEPH

Last Name

MUSALLAM

Suffix

Business Name

JACOB JOSEPH MUSALLAM MD

Original Issue Date

05/22/1975

Effective Date

05/22/1975

Expiration Date

07/01/1982

City

PHOENIX

State

Zip

85008

County

ARIZONA

Ever Disciplined

LastModifiedDate

09/20/2006