BASSIL KHERALLAH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125075267

License Status

CANCELLED

Business

Title

First Name

BASSIL

Last Name

KHERALLAH

Business Name

BASSIL KHERALLAH MD

Original Issue Date

07/01/2022

Effective Date

07/01/2022

Expiration Date

06/30/2023

City

PEORIA

State

Zip

61603

County

PEORIA

Specialty/Qualifier

Neurology

Ever Disciplined

LastModifiedDate

04/29/2022