MUFADDAL MUSTAFA GOMBERA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****59

License Status

NOT RENEWED

Business

First Name

MUFADDAL

Middle

MUSTAFA

Last Name

GOMBERA

Business Name

MUFADDAL MUSTAFA GOMBERA

Original Issue Date

08/12/2014

Effective Date

08/12/2014

Expiration Date

07/31/2017

City

GURNEE

State

Zip

60031

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017