EFESOMWAN AISIEN MD - Medical Doctor License in Illinois | # 125061360

EFESOMWAN AISIEN MD

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125061360

License Status

CANCELLED

Business

N

Title

MD

First Name

EFESOMWAN

Last Name

AISIEN

Business Name

EFESOMWAN AISIEN MD

Original Issue Date

07/01/2012

Effective Date

07/01/2012

Expiration Date

06/30/2015

State

IL

Specialty/Qualifier

Internal Medicine

Ever Disciplined

N

LastModifiedDate

06/05/2015