ILIA ROSA SUMOZA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****71

License Status

ACTIVE

Business

First Name

ILIA

Middle

ROSA

Last Name

SUMOZA

Suffix

Business Name

ILIA ROSA SUMOZA MD

Original Issue Date

04/30/2018

Effective Date

04/28/2023

Expiration Date

07/31/2026

City

DARIEN

State

Zip

60561

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/28/2023