MAZEN KHERALLAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

NOT RENEWED

Business

First Name

MAZEN

Last Name

KHERALLAH

Suffix

Business Name

MAZEN KHERALLAH MD

Original Issue Date

09/13/1991

Effective Date

09/13/1991

Expiration Date

07/31/1996

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020