FADOL MOHAMED OSMAN FADOL MOHAMED MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****18

License Status

ACTIVE

Business

Title

First Name

FADOL

Middle

MOHAMED OSMAN FADOL

Last Name

MOHAMED

Business Name

FADOL MOHAMED OSMAN FADOL MOHAMED MD

Original Issue Date

12/22/2023

Effective Date

12/22/2023

Expiration Date

07/31/2026

City

BETHPAGE

State

Zip

11714

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/22/2023