WALLACE KENJI NAKAGAWA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036062734

License Status

NOT RENEWED

Business

First Name

WALLACE KENJI

Last Name

NAKAGAWA

Suffix

Business Name

WALLACE KENJI NAKAGAWA MD

Original Issue Date

08/03/1981

Effective Date

08/03/1981

Expiration Date

07/31/1993

City

VILLA GROVE

State

Zip

61956

County

DOUGLAS

Ever Disciplined

LastModifiedDate

09/20/2006

Case Number

1993001877

Action

Suspension

Discipline Start Date

10/20/1994

Discipline Reason

Failing to pay Illinois income tax in 1986, and failing to file tax returns from 1987-1989.