EBENEZER EDGAR ENCHIA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074544

License Status

CANCELLED

Business

Title

First Name

EBENEZER

Middle

EDGAR

Last Name

ENCHIA

Business Name

EBENEZER EDGAR ENCHIA MD

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2021

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Preventive Medicine – Occupational Medicine

Ever Disciplined

LastModifiedDate

10/17/2019