FARES GHANEM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125081176

License Status

ACTIVE

Business

Title

First Name

FARES

Last Name

GHANEM

Business Name

FARES GHANEM MD

Original Issue Date

07/01/2023

Effective Date

07/01/2023

Expiration Date

06/30/2026

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Cardiovascular Disease

Ever Disciplined

LastModifiedDate

04/04/2023