MARK NABIL FEKRY MASSOUD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****49

License Status

NOT RENEWED

Business

Title

First Name

MARK

Middle

NABIL FEKRY

Last Name

MASSOUD

Business Name

MARK NABIL FEKRY MASSOUD MD

Original Issue Date

06/21/2017

Effective Date

07/29/2020

Expiration Date

07/31/2023

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023