MAZEN KHALIL KHALIL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****73

License Status

NOT RENEWED

Business

Title

First Name

MAZEN

Middle

KHALIL

Last Name

KHALIL

Business Name

MAZEN KHALIL KHALIL MD

Original Issue Date

11/01/2017

Effective Date

11/01/2017

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62769

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021