EDSEL IWAY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****54

License Status

NOT RENEWED

Business

Title

First Name

EDSEL

Last Name

IWAY

Business Name

EDSEL IWAY MD

Original Issue Date

09/04/2013

Effective Date

09/04/2013

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2017