JAD JOSEPH WAKIM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****13

License Status

NOT RENEWED

Business

Title

First Name

JAD

Middle

JOSEPH

Last Name

WAKIM

Business Name

JAD JOSEPH WAKIM MD

Original Issue Date

01/31/2022

Effective Date

01/31/2022

Expiration Date

07/31/2023

City

ROCKFORD

State

Zip

61114

County

BOONE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023