MIA M SONG 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

MIA

Middle

Last Name

SONG

Business Name

MIA M SONG

Original Issue Date

10/30/2001

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60602

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2023