TESFU LISANEWORK HAILU MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****79

License Status

ACTIVE

Business

Title

First Name

TESFU

Middle

LISANEWORK

Last Name

HAILU

Business Name

TESFU LISANEWORK HAILU MD

Original Issue Date

03/21/2022

Effective Date

05/17/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61614

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/17/2023