MUSTAFA ISMAIL AHMED MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****81

License Status

NOT RENEWED

Business

Title

First Name

MUSTAFA

Middle

ISMAIL

Last Name

AHMED

Business Name

MUSTAFA ISMAIL AHMED MD

Original Issue Date

05/28/2013

Effective Date

05/08/2014

Expiration Date

07/31/2017

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017