KOJI TAKEDA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058991

License Status

EXPIRED

Business

First Name

KOJI

Last Name

TAKEDA

Suffix

Business Name

KOJI TAKEDA MD

Original Issue Date

10/25/2010

Effective Date

10/25/2010

Expiration Date

10/24/2012

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Adult Cardiac Surgery

Ever Disciplined

LastModifiedDate

01/11/2013