MUSTAFA IBRAHIM MUSA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****17

License Status

NOT RENEWED

Business

First Name

MUSTAFA IBRAHIM

Last Name

MUSA

Suffix

Business Name

MUSTAFA IBRAHIM MUSA MD

Original Issue Date

09/17/1996

Effective Date

09/17/1996

Expiration Date

07/31/2002

City

VANDALIA

State

Zip

62471

County

CLINTON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006