IBRAHEEM M MIZYED MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****08

License Status

NOT RENEWED

Business

Title

First Name

IBRAHEEM

Middle

Last Name

MIZYED

Business Name

IBRAHEEM M MIZYED MD

Original Issue Date

05/25/2016

Effective Date

05/25/2016

Expiration Date

07/31/2017

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017