HANI ISSA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050623

License Status

CANCELLED

Business

First Name

HANI

Last Name

ISSA

Suffix

Business Name

HANI ISSA MD

Original Issue Date

06/26/2008

Effective Date

06/26/2008

Expiration Date

06/25/2009

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

03/16/2009