MANAL EMAD MOUSTAFA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****41

License Status

NOT RENEWED

Business

Title

First Name

MANAL

Middle

EMAD

Last Name

MOUSTAFA

Business Name

MANAL EMAD MOUSTAFA MD

Original Issue Date

04/24/2019

Effective Date

04/24/2019

Expiration Date

09/30/2020

City

ATLANTA

State

Zip

30324

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021