FAYEK NICHOLAS SHAMMA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

NOT RENEWED

Business

First Name

FAYEK

Middle

NICHOLAS

Last Name

SHAMMA

Suffix

Business Name

FAYEK NICHOLAS SHAMMA MD

Original Issue Date

02/20/2004

Effective Date

06/22/2011

Expiration Date

07/31/2014

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Controlled Substance Schedule

III

Ever Disciplined

LastModifiedDate

04/05/2020