FADI MOHAMAD MUSTAPHA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****48

License Status

ACTIVE

Business

First Name

FADI

Middle

MOHAMAD

Last Name

MUSTAPHA

Suffix

Business Name

FADI MOHAMAD MUSTAPHA MD

Original Issue Date

05/15/2006

Effective Date

06/15/2023

Expiration Date

07/31/2026

City

DIXON

State

Zip

61021

County

LEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/15/2023