AYAME TAKAHASHI Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****88

License Status

ACTIVE

Business

First Name

AYAME

Last Name

TAKAHASHI

Business Name

AYAME TAKAHASHI

Original Issue Date

10/03/2006

Effective Date

07/20/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/20/2023