EDGAR JOSEPH MASSABNI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****13

License Status

NOT RENEWED

Business

Title

First Name

EDGAR

Middle

JOSEPH

Last Name

MASSABNI

Business Name

EDGAR JOSEPH MASSABNI MD

Original Issue Date

08/24/2020

Effective Date

08/24/2020

Expiration Date

07/31/2023

City

GREEN BAY

State

Zip

54313

County

BROWN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023