NOSSA W MAYA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****19

License Status

NOT RENEWED

Business

First Name

NOSSA

Middle

Last Name

MAYA

Suffix

Business Name

NOSSA W MAYA MD

Original Issue Date

12/23/2008

Effective Date

07/06/2011

Expiration Date

07/31/2014

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014