PHYLLIS IJEAMAKA EZE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036131066

License Status

ACTIVE

Business

Title

First Name

PHYLLIS

Middle

IJEAMAKA

Last Name

EZE

Business Name

PHYLLIS IJEAMAKA EZE MD

Original Issue Date

08/06/2012

Effective Date

07/24/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/24/2023