MODUPE A OLADEINDE Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****35

License Status

NOT RENEWED

Business

First Name

MODUPE

Middle

Last Name

OLADEINDE

Business Name

MODUPE A OLADEINDE

Original Issue Date

11/18/2004

Effective Date

05/23/2017

Expiration Date

09/30/2020

City

SOUTH HOLLAND

State

Zip

60473

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021