EFESOMWAN AISIEN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125061360

License Status

CANCELLED

Business

Title

First Name

EFESOMWAN

Last Name

AISIEN

Business Name

EFESOMWAN AISIEN MD

Original Issue Date

07/01/2012

Effective Date

07/01/2012

Expiration Date

06/30/2015

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

06/05/2015