ADERONKE O BAMGBOSE PEDERSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****84

License Status

NOT RENEWED

Business

Title

First Name

ADERONKE

Middle

Last Name

BAMGBOSE PEDERSON

Business Name

ADERONKE O BAMGBOSE PEDERSON MD

Original Issue Date

08/30/2017

Effective Date

09/22/2020

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023