TAKASHI NISHIDA 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

TAKASHI

Last Name

NISHIDA

Suffix

Business Name

TAKASHI NISHIDA MD

Original Issue Date

01/01/1997

Effective Date

06/07/2023

Expiration Date

07/31/2026

City

WILLOWBROOK

State

Zip

60521

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/07/2023