MAXIMILIANO A TAMAE KAKAZU MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

NOT RENEWED

Business

First Name

MAXIMILIANO

Middle

Last Name

TAMAE KAKAZU

Suffix

Business Name

MAXIMILIANO A TAMAE KAKAZU MD

Original Issue Date

08/15/2011

Effective Date

08/15/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014