IHSAN MAMOUN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****61

License Status

NOT RENEWED

Business

Title

First Name

IHSAN

Last Name

MAMOUN

Business Name

IHSAN MAMOUN MD

Original Issue Date

09/25/2017

Effective Date

09/25/2017

Expiration Date

09/30/2020

City

WESTLAKE

State

Zip

44145

County

OHIO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

01/14/2021