CHIOMA PAMELA EZEANI MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125060361

License Status

CANCELLED

Business

Title

First Name

CHIOMA

Middle

PAMELA

Last Name

EZEANI

Business Name

CHIOMA PAMELA EZEANI MD

Original Issue Date

06/25/2011

Effective Date

06/25/2011

Expiration Date

06/24/2014

City

LIBERTYVILLE

State

Zip

60048

County

LAKE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/24/2011