MAMAK EATESAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****83

License Status

NOT RENEWED

Business

Title

First Name

MAMAK

Last Name

EATESAM

Business Name

MAMAK EATESAM MD

Original Issue Date

12/18/2013

Effective Date

08/25/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020