CORY T MIYAMOTO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

NOT RENEWED

Business

First Name

CORY

Middle

Last Name

MIYAMOTO

Business Name

CORY T MIYAMOTO

Original Issue Date

04/21/2005

Effective Date

04/21/2005

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008