SHAFIK HANNA-MOUSSA 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

SHAFIK

Last Name

HANNA-MOUSSA

Suffix

Business Name

SHAFIK HANNA-MOUSSA MD

Original Issue Date

11/08/2005

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011