BASANT FARGHALY MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048640

License Status

EXPIRED

Business

First Name

BASANT

Last Name

FARGHALY

Suffix

Business Name

BASANT FARGHALY MD

Original Issue Date

06/28/2004

Effective Date

06/28/2004

Expiration Date

06/27/2007

City

ST AUGUSTINE

State

Zip

32092

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

07/03/2007