HAITHAM HASSAN AHMED HASSANE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****10

License Status

ACTIVE

Business

Title

First Name

HAITHAM

Middle

HASSAN AHMED

Last Name

HASSANE

Business Name

HAITHAM HASSAN AHMED HASSANE MD

Original Issue Date

06/15/2018

Effective Date

07/03/2023

Expiration Date

07/31/2026

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/03/2023