GHOLAM R HAFEZ MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036046924

License Status

INACTIVE

Business

First Name

GHOLAM R

Last Name

HAFEZ

Suffix

Business Name

GHOLAM R HAFEZ MD

Original Issue Date

02/07/1973

Effective Date

02/07/1973

Expiration Date

07/31/1987

City

MADISON

State

Zip

53717

County

WISCONSIN

Ever Disciplined

LastModifiedDate

09/20/2006