MATTHEW EDGAR ENRIQUEZ MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****21

License Status

ACTIVE

Business

Title

First Name

MATTHEW

Middle

EDGAR

Last Name

ENRIQUEZ

Business Name

MATTHEW EDGAR ENRIQUEZ MD

Original Issue Date

04/05/2017

Effective Date

07/27/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2023