IMAD M AL-BASHA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

NOT RENEWED

Business

First Name

IMAD M

Last Name

AL-BASHA

Suffix

Business Name

IMAD M AL-BASHA MD

Original Issue Date

09/08/1989

Effective Date

09/08/1989

Expiration Date

07/31/1996

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020