SHUROUK I ISMAIL 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

First Name

SHUROUK

Middle

Last Name

ISMAIL

Business Name

SHUROUK I ISMAIL

Original Issue Date

07/25/2008

Effective Date

07/31/2014

Expiration Date

07/31/2017

City

PEORIA

State

Zip

61615

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017