KIMIKO L ISHIBASHI 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

First Name

KIMIKO

Middle

Last Name

ISHIBASHI

Business Name

KIMIKO L ISHIBASHI

Original Issue Date

02/05/2007

Effective Date

02/05/2007

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008