TRAVIS TAKANORI YAMANAKA 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

TRAVIS

Middle

TAKANORI

Last Name

YAMANAKA

Business Name

TRAVIS TAKANORI YAMANAKA MD

Original Issue Date

11/04/2011

Effective Date

04/12/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60646

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2023