WAIL EDRIS ASFOUR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****97

License Status

NOT RENEWED

Business

First Name

WAIL

Middle

EDRIS

Last Name

ASFOUR

Suffix

Business Name

WAIL EDRIS ASFOUR MD

Original Issue Date

11/16/2000

Effective Date

11/16/2000

Expiration Date

07/31/2002

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020