MA EDEN NAGANO ELVAMBUENA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036096707

License Status

NOT RENEWED

Business

First Name

MA EDEN NAGANO

Last Name

ELVAMBUENA

Suffix

Business Name

MA EDEN NAGANO ELVAMBUENA MD

Original Issue Date

09/12/1997

Effective Date

09/12/1997

Expiration Date

07/31/1999

City

BERWYN

State

Zip

60402

County

COOK

Ever Disciplined

LastModifiedDate

11/22/2010