DJAMEL BOUAZZA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****82

License Status

NOT RENEWED

Business

First Name

DJAMEL

Last Name

BOUAZZA

Suffix

Business Name

DJAMEL BOUAZZA MD

Original Issue Date

02/29/2000

Effective Date

02/29/2000

Expiration Date

07/31/2005

City

MARYVILLE

State

Zip

62062

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006