PHYLLIS IJEAMAKA EZE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

ACTIVE

Business

Title

First Name

PHYLLIS

Middle

IJEAMAKA

Last Name

EZE

Business Name

PHYLLIS IJEAMAKA EZE MD

Original Issue Date

08/06/2012

Effective Date

07/24/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/24/2023