ABDISAMAD MOHAMED IBRAHIM MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125070314

License Status

EXPIRED

Business

Title

First Name

ABDISAMAD

Middle

MOHAMED

Last Name

IBRAHIM

Business Name

ABDISAMAD MOHAMED IBRAHIM MD

Original Issue Date

06/26/2017

Effective Date

06/26/2017

Expiration Date

06/25/2020

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

11/19/2020