BASSIL KHERALLAH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

ACTIVE

Business

Title

First Name

BASSIL

Last Name

KHERALLAH

Business Name

BASSIL KHERALLAH MD

Original Issue Date

07/25/2023

Effective Date

07/25/2023

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

07/25/2023