EBENEZER EDGAR ENCHIA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****03

License Status

NOT RENEWED

Business

Title

First Name

EBENEZER

Middle

EDGAR

Last Name

ENCHIA

Business Name

EBENEZER EDGAR ENCHIA MD

Original Issue Date

11/15/2019

Effective Date

08/10/2020

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60607

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023