SALIM SHACKOUR MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

ACTIVE

Business

Title

First Name

SALIM

Last Name

SHACKOUR

Business Name

SALIM SHACKOUR MD

Original Issue Date

07/19/2007

Effective Date

04/10/2023

Expiration Date

07/31/2026

City

DECATUR

State

Zip

62521

County

MACON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/10/2023