OMOLOLU D OMOWANILE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

ACTIVE

Business

Title

First Name

OMOLOLU

Middle

Last Name

OMOWANILE

Business Name

OMOLOLU D OMOWANILE MD

Original Issue Date

04/19/2019

Effective Date

06/30/2023

Expiration Date

07/31/2026

City

MONROE

State

Zip

53566

County

WISCONSIN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/30/2023