MEAZA M MENGISTU MD 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

MEAZA

Middle

Last Name

MENGISTU

Suffix

Business Name

MEAZA M MENGISTU MD

Original Issue Date

06/21/2002

Effective Date

08/31/2023

Expiration Date

07/31/2026

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/31/2023