FASIL F MOHOMED Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047086

License Status

EXPIRED

Business

First Name

FASIL

Middle

Last Name

MOHOMED

Business Name

FASIL F MOHOMED

Original Issue Date

08/25/2003

Effective Date

08/25/2003

Expiration Date

08/24/2006

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006