HIDETAKA KITAZONO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

NOT RENEWED

Business

Title

First Name

HIDETAKA

Last Name

KITAZONO

Business Name

HIDETAKA KITAZONO MD

Original Issue Date

09/08/2008

Effective Date

09/08/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

11/10/2011