ISLAMIAT O EGO-OSUALA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****48

License Status

NOT RENEWED

Business

Title

First Name

ISLAMIAT

Middle

Last Name

EGO-OSUALA

Business Name

ISLAMIAT O EGO-OSUALA MD

Original Issue Date

02/08/2017

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

CRYSTAL LAKE

State

Zip

60014

County

DISTRICT OF COLUMBIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021