EFESOMWAN AISIEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

NOT RENEWED

Business

Title

First Name

EFESOMWAN

Last Name

AISIEN

Business Name

EFESOMWAN AISIEN MD

Original Issue Date

07/08/2015

Effective Date

05/08/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021