FRI NGUM AWASUM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****27

License Status

ACTIVE

Business

Title

First Name

FRI

Middle

NGUM

Last Name

AWASUM

Business Name

FRI NGUM AWASUM MD

Original Issue Date

09/20/2021

Effective Date

04/15/2023

Expiration Date

07/31/2026

State

Zip

60652

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/15/2023