MAZIN SHACKOUR Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****44

License Status

ACTIVE

Business

First Name

MAZIN

Last Name

SHACKOUR

Business Name

MAZIN SHACKOUR

Original Issue Date

08/13/2024

Effective Date

08/13/2024

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/13/2024