MARYAM N SANDOVAL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****89

License Status

ACTIVE

Business

First Name

MARYAM

Middle

Last Name

SANDOVAL

Suffix

Business Name

MARYAM N SANDOVAL MD

Original Issue Date

03/19/1999

Effective Date

06/15/2023

Expiration Date

07/31/2026

City

ELMHURST

State

Zip

60126

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/15/2023