EDEM STEFANO K AGAMAH Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****01

License Status

NOT RENEWED

Business

First Name

EDEM STEFANO K

Last Name

AGAMAH

Business Name

EDEM STEFANO K AGAMAH

Original Issue Date

08/31/1993

Effective Date

08/31/1993

Expiration Date

07/31/1996

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020