MALIK GHANNAM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036173161

License Status

ACTIVE

Business

Title

First Name

MALIK

Last Name

GHANNAM

Business Name

MALIK GHANNAM MD

Original Issue Date

12/22/2024

Effective Date

12/22/2024

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

12/22/2024