CAMILLE ANGELO ENRIQUEZ Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****17

License Status

ACTIVE

Business

First Name

CAMILLE

Middle

ANGELO

Last Name

ENRIQUEZ

Business Name

CAMILLE ANGELO ENRIQUEZ

Original Issue Date

03/12/2020

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023