HESHAM M ELGHANNAM Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036111514

License Status

NOT RENEWED

Business

First Name

HESHAM

Middle

Last Name

ELGHANNAM

Business Name

HESHAM M ELGHANNAM

Original Issue Date

06/01/2004

Effective Date

11/30/2017

Expiration Date

09/30/2020

City

BROOKFIELD

State

Zip

53045

County

WISCONSIN

Ever Disciplined

LastModifiedDate

01/14/2021