EDEM STEFANO K AGAMAH Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

ACTIVE

Business

First Name

EDEM STEFANO K

Last Name

AGAMAH

Business Name

EDEM STEFANO K AGAMAH

Original Issue Date

08/21/1992

Effective Date

04/23/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/23/2023