JEFFREY L KISHIYAMA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****12

License Status

NOT RENEWED

Business

First Name

JEFFREY L

Last Name

KISHIYAMA

Suffix

Business Name

JEFFREY L KISHIYAMA MD

Original Issue Date

04/12/1991

Effective Date

04/12/1991

Expiration Date

07/31/1993

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006