BASIL HUSAYN HAZIMAH DPM Podiatrist License verification

Business Entity

INACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016005370

License Status

INACTIVE

Business

First Name

BASIL

Middle

HUSAYN

Last Name

HAZIMAH

Suffix

DPM

Business Name

BASIL HUSAYN HAZIMAH DPM

Original Issue Date

06/03/2008

Effective Date

11/08/2020

Expiration Date

01/31/2023

City

MAUMEE

State

Zip

43537

Ever Disciplined

LastModifiedDate

01/28/2023