BASEM AWADH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****51

License Status

NOT RENEWED

Business

Title

First Name

BASEM

Last Name

AWADH

Business Name

BASEM AWADH MD

Original Issue Date

06/19/2012

Effective Date

04/16/2014

Expiration Date

07/31/2017

City

PEORIA

State

Zip

61603

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017