MAXIMILIANO A TAMAE KAKAZU MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

NOT RENEWED

Business

First Name

MAXIMILIANO

Middle

Last Name

TAMAE KAKAZU

Suffix

Business Name

MAXIMILIANO A TAMAE KAKAZU MD

Original Issue Date

05/21/2009

Effective Date

05/21/2009

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60617

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/21/2012