OMAR FASIH AHMED DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125069838

License Status

CANCELLED

Business

Title

First Name

OMAR

Middle

FASIH

Last Name

AHMED

Business Name

OMAR FASIH AHMED DO

Original Issue Date

07/01/2017

Effective Date

07/01/2017

Expiration Date

06/30/2020

City

PEORIA

State

Zip

61636

County

MONROE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

04/10/2017