ABDALLAH MOHAMED JEROUDI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****07

License Status

NOT RENEWED

Business

Title

First Name

ABDALLAH

Middle

MOHAMED

Last Name

JEROUDI

Business Name

ABDALLAH MOHAMED JEROUDI MD

Original Issue Date

06/03/2015

Effective Date

06/03/2015

Expiration Date

07/31/2017

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017