TOMMY ADEL IBRAHIM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****98

License Status

NOT RENEWED

Business

First Name

TOMMY

Middle

ADEL

Last Name

IBRAHIM

Suffix

Business Name

TOMMY ADEL IBRAHIM MD

Original Issue Date

06/04/2010

Effective Date

05/30/2017

Expiration Date

09/30/2020

City

WILDWOOD

State

Zip

63038

County

JACKSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021