ABIOLA O FAMILUSI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

NOT RENEWED

Business

Title

First Name

ABIOLA

Middle

Last Name

FAMILUSI

Business Name

ABIOLA O FAMILUSI MD

Original Issue Date

02/25/2020

Effective Date

02/25/2020

Expiration Date

09/30/2020

City

FAR ROCKAWAY

State

Zip

11691

County

NEW YORK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021