SAM BISHARA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125042443

License Status

CANCELLED

Business

First Name

SAM

Last Name

BISHARA

Suffix

Business Name

SAM BISHARA MD

Original Issue Date

07/01/2001

Effective Date

07/01/2001

Expiration Date

06/30/2002

City

ALTON

State

Zip

62002

County

MADISON

Ever Disciplined

LastModifiedDate

09/22/2006