BASIL EID JARADAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036132195

License Status

NOT RENEWED

Business

Title

First Name

BASIL

Middle

EID

Last Name

JARADAH

Business Name

BASIL EID JARADAH MD

Original Issue Date

04/01/2013

Effective Date

07/11/2014

Expiration Date

07/31/2017

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

11/01/2017