ERNA MARIA OBENZA NISHIME Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

NOT RENEWED

Business

First Name

ERNA MARIA

Last Name

OBENZA NISHIME

Business Name

ERNA MARIA OBENZA NISHIME

Original Issue Date

05/19/1997

Effective Date

05/19/1997

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011