NASSIR HASSAN MONIM MANSOUR MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****77

License Status

ACTIVE

Business

Title

First Name

NASSIR

Middle

HASSAN MONIM

Last Name

MANSOUR

Business Name

NASSIR HASSAN MONIM MANSOUR MD

Original Issue Date

01/09/2015

Effective Date

04/18/2023

Expiration Date

07/31/2026

City

BROOKLYN

State

Zip

11225

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/18/2023