IVIE DORIS ESANGBEDO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

NOT RENEWED

Business

First Name

IVIE

Middle

DORIS

Last Name

ESANGBEDO

Suffix

Business Name

IVIE DORIS ESANGBEDO MD

Original Issue Date

01/24/2011

Effective Date

07/11/2017

Expiration Date

09/30/2020

City

DALLAS

State

Zip

75201

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021