BASEM HADDAD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****62

License Status

NOT RENEWED

Business

First Name

BASEM

Last Name

HADDAD

Suffix

Business Name

BASEM HADDAD MD

Original Issue Date

06/27/2003

Effective Date

06/27/2003

Expiration Date

07/31/2005

City

SPRINGFIELD

State

Zip

92794

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006