PRINCE OSAZUWA EHIMAMIEGHO MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125080013

License Status

CANCELLED

Business

Title

First Name

PRINCE

Middle

OSAZUWA

Last Name

EHIMAMIEGHO

Business Name

PRINCE OSAZUWA EHIMAMIEGHO MD

Original Issue Date

07/01/2022

Effective Date

07/01/2022

Expiration Date

06/30/2025

City

PEORIA

State

Zip

61605

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

12/10/2024