MATILDA MARK ROSANWO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

NOT RENEWED

Business

First Name

MATILDA

Middle

MARK

Last Name

ROSANWO

Suffix

Business Name

MATILDA MARK ROSANWO MD

Original Issue Date

03/14/2018

Effective Date

03/14/2018

Expiration Date

09/30/2020

City

WEST DUNDEE

State

Zip

60118

County

KANE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021