SHADY BASSAM HAWATMEH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036144729

License Status

NOT RENEWED

Business

Title

First Name

SHADY

Middle

BASSAM

Last Name

HAWATMEH

Business Name

SHADY BASSAM HAWATMEH MD

Original Issue Date

12/05/2017

Effective Date

09/16/2020

Expiration Date

07/31/2023

City

MANCHESTER

State

Zip

63021

Ever Disciplined

LastModifiedDate

11/30/2023