HASAN FADHIL HAMAD AL-AZZAWI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****21

License Status

NOT RENEWED

Business

Title

First Name

HASAN FADHIL

Middle

HAMAD

Last Name

AL-AZZAWI

Business Name

HASAN FADHIL HAMAD AL-AZZAWI MD

Original Issue Date

07/10/2014

Effective Date

07/10/2014

Expiration Date

07/31/2017

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017