AFOMA PHOEBE EZIDINMA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****60

License Status

ACTIVE

Business

Title

First Name

AFOMA

Middle

PHOEBE

Last Name

EZIDINMA

Business Name

AFOMA PHOEBE EZIDINMA MD

Original Issue Date

04/06/2010

Effective Date

07/22/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60657

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/22/2023