KHALED OMAR ELBANNA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045458

License Status

CANCELLED

Business

Title

First Name

KHALED

Middle

OMAR

Last Name

ELBANNA

Business Name

KHALED OMAR ELBANNA MD

Original Issue Date

12/02/2002

Effective Date

12/02/2002

Expiration Date

05/31/2003

City

EFFINGHAM

State

Zip

62401

County

EFFINGHAM

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006