AMERA REFAT MOHAMED GABALLA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

NOT RENEWED

Business

First Name

AMERA REFAT

Middle

MOHAMED

Last Name

GABALLA

Suffix

Business Name

AMERA REFAT MOHAMED GABALLA MD

Original Issue Date

12/28/2006

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021