LUIS CARLOS WATANABE TEJADA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****45

License Status

NOT RENEWED

Business

Title

First Name

LUIS

Middle

CARLOS

Last Name

WATANABE TEJADA

Business Name

LUIS CARLOS WATANABE TEJADA MD

Original Issue Date

06/19/2015

Effective Date

06/19/2015

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

04/05/2020