SHAHEDA M MANSURI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

ACTIVE

Business

First Name

SHAHEDA

Middle

Last Name

MANSURI

Suffix

Business Name

SHAHEDA M MANSURI MD

Original Issue Date

06/17/1985

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

CARTERVILLE

State

Zip

62918

County

WILLIAMSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2023