BASSAM NICHOLAS SHAMMA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036106937

License Status

NOT RENEWED

Business

First Name

BASSAM

Middle

NICHOLAS

Last Name

SHAMMA

Suffix

Business Name

BASSAM NICHOLAS SHAMMA MD

Original Issue Date

05/10/2002

Effective Date

05/10/2002

Expiration Date

07/31/2005

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

10/09/2006