IBRAHIM N MANSOUR MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048664

License Status

EXPIRED

Business

First Name

IBRAHIM

Middle

Last Name

MANSOUR

Suffix

Business Name

IBRAHIM N MANSOUR MD

Original Issue Date

06/30/2004

Effective Date

06/30/2004

Expiration Date

06/29/2007

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

07/03/2007