SHADI ADEL ALTWAL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****33

License Status

ACTIVE

Business

First Name

SHADI

Middle

ADEL

Last Name

ALTWAL

Suffix

Business Name

SHADI ADEL ALTWAL MD

Original Issue Date

01/04/2005

Effective Date

05/03/2023

Expiration Date

07/31/2026

City

BELLEVILLE

State

Zip

62226

County

EFFINGHAM

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/03/2023