WISSAM FOUAD DERIAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036113096

License Status

ACTIVE

Business

First Name

WISSAM

Middle

FOUAD

Last Name

DERIAN

Suffix

Business Name

WISSAM FOUAD DERIAN MD

Original Issue Date

02/18/2005

Effective Date

04/18/2023

Expiration Date

07/31/2026

City

QUINCY

State

Zip

62301

Ever Disciplined

LastModifiedDate

09/29/2023