IHSAN M SALLOUM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

NOT RENEWED

Business

First Name

IHSAN M

Last Name

SALLOUM

Suffix

Business Name

IHSAN M SALLOUM MD

Original Issue Date

04/29/1987

Effective Date

04/29/1987

Expiration Date

07/31/1990

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006