HAYTHAM MANSOUR Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****08

License Status

NOT RENEWED

Business

First Name

HAYTHAM

Last Name

MANSOUR

Business Name

HAYTHAM MANSOUR

Original Issue Date

07/29/2008

Effective Date

12/02/2008

Expiration Date

01/31/2011

City

YORKVILLE

State

Zip

60560

County

KENDALL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/10/2011