HESHAM M ELGHANNAM Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****14

License Status

CANCELLED

Business

First Name

HESHAM

Middle

Last Name

ELGHANNAM

Business Name

HESHAM M ELGHANNAM

Original Issue Date

12/30/2004

Effective Date

12/30/2004

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020