EBEHIREME EKANEM IBAZEBO MD - Medical Doctor License in Pennsylvania | # 33*****22

EBEHIREME EKANEM IBAZEBO MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****22

License Status

NOT RENEWED

Business

N

Title

MD

First Name

EBEHIREME

Middle

EKANEM

Last Name

IBAZEBO

Business Name

EBEHIREME EKANEM IBAZEBO MD

Original Issue Date

12/21/2020

Effective Date

12/21/2020

Expiration Date

07/31/2023

State

PA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

N

LastModifiedDate

11/30/2023