PRINCE OSAZUWA EHIMAMIEGHO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

ACTIVE

Business

Title

First Name

PRINCE

Middle

OSAZUWA

Last Name

EHIMAMIEGHO

Business Name

PRINCE OSAZUWA EHIMAMIEGHO MD

Original Issue Date

12/10/2024

Effective Date

12/10/2024

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/10/2024