MATILDA MARK ROSANWO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

ACTIVE

Business

First Name

MATILDA

Middle

MARK

Last Name

ROSANWO

Suffix

Business Name

MATILDA MARK ROSANWO MD

Original Issue Date

08/13/2001

Effective Date

06/29/2023

Expiration Date

07/31/2026

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/29/2023