SAMUEL YIGEZU TESFAY Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

NOT RENEWED

Business

First Name

SAMUEL

Middle

YIGEZU

Last Name

TESFAY

Business Name

SAMUEL YIGEZU TESFAY

Original Issue Date

02/20/2008

Effective Date

02/20/2008

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008