MARK TSUNEO WAKABAYASHI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

NOT RENEWED

Business

First Name

MARK

Middle

TSUNEO

Last Name

WAKABAYASHI

Suffix

Business Name

MARK TSUNEO WAKABAYASHI MD

Original Issue Date

07/05/2000

Effective Date

07/05/2000

Expiration Date

07/31/2005

City

MAYWOOD

State

Zip

60153

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006