BOLANLE SOYANNWO BALOGUN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****12

License Status

ACTIVE

Business

Title

First Name

BOLANLE

Last Name

SOYANNWO BALOGUN

Business Name

BOLANLE SOYANNWO BALOGUN MD

Original Issue Date

08/06/2008

Effective Date

04/18/2023

Expiration Date

07/31/2026

City

LIBERTYVILLE

State

Zip

60048

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/18/2023