IMANI R ANWISYE-MASHELE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****68

License Status

ACTIVE

Business

Title

First Name

IMANI

Middle

Last Name

ANWISYE-MASHELE

Business Name

IMANI R ANWISYE-MASHELE MD

Original Issue Date

10/26/2015

Effective Date

06/27/2023

Expiration Date

07/31/2026

City

URBANA

State

Zip

61802

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/27/2023