HAYAT M MOUSA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****16

License Status

NOT RENEWED

Business

First Name

HAYAT

Middle

Last Name

MOUSA

Suffix

Business Name

HAYAT M MOUSA MD

Original Issue Date

09/15/1998

Effective Date

09/15/1998

Expiration Date

07/31/2002

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

10/09/2006