SHAJI A MOHAMMED DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125075075

License Status

CANCELLED

Business

Title

First Name

SHAJI

Middle

Last Name

MOHAMMED

Prefix

Business Name

SHAJI A MOHAMMED DO

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2022

City

MOUNT VERNON

State

Zip

62864

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/20/2019