KHADRAH MOUSA O ALSOMALI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****17

License Status

ACTIVE

Business

Title

First Name

KHADRAH

Middle

MOUSA O

Last Name

ALSOMALI

Business Name

KHADRAH MOUSA O ALSOMALI MD

Original Issue Date

05/06/2021

Effective Date

04/26/2023

Expiration Date

07/31/2026

City

CARBONDALE

State

Zip

62901

County

ADAMS

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/26/2023