BRANDON ETHAN SUMIDA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074828

License Status

EXPIRED

Business

Title

First Name

BRANDON

Middle

ETHAN

Last Name

SUMIDA

Business Name

BRANDON ETHAN SUMIDA MD

Original Issue Date

06/23/2019

Effective Date

06/23/2019

Expiration Date

06/22/2022

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

10/11/2022