HOUSAM EDEN SOUKIEH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

NOT RENEWED

Business

First Name

HOUSAM

Middle

EDEN

Last Name

SOUKIEH

Suffix

Business Name

HOUSAM EDEN SOUKIEH MD

Original Issue Date

09/17/1999

Effective Date

06/22/2017

Expiration Date

09/30/2020

City

PEKIN

State

Zip

61554

County

TAZEWELL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021