YAZEED MAZEN GUSSOUS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

NOT RENEWED

Business

Title

First Name

YAZEED

Middle

MAZEN

Last Name

GUSSOUS

Business Name

YAZEED MAZEN GUSSOUS MD

Original Issue Date

05/25/2016

Effective Date

05/25/2016

Expiration Date

07/31/2017

City

CHESTNUT HILLS

State

Zip

02467

County

MASSACHUSETTS

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020