DINA YOUSSEF BOUTROS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

NOT RENEWED

Business

Title

First Name

DINA

Middle

YOUSSEF

Last Name

BOUTROS

Business Name

DINA YOUSSEF BOUTROS MD

Original Issue Date

10/09/2014

Effective Date

08/01/2017

Expiration Date

09/30/2020

City

COPLEY

State

Zip

44321

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

01/14/2021