SUZANNE GHANNAM Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057100

License Status

CANCELLED

Business

First Name

SUZANNE

Last Name

GHANNAM

Business Name

SUZANNE GHANNAM

Original Issue Date

06/24/2009

Effective Date

06/24/2009

Expiration Date

06/23/2012

City

CHARLESTON

State

Zip

25364

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

06/04/2009