TYEESE LATEEFA GAINES DO - Medical Doctor License in New York | # 33*****32

TYEESE LATEEFA GAINES DO

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****32

License Status

ACTIVE

Business

N

Title

DO

First Name

TYEESE

Middle

LATEEFA

Last Name

GAINES

Business Name

TYEESE LATEEFA GAINES DO

Original Issue Date

12/02/2016

Effective Date

07/10/2023

Expiration Date

07/31/2026

State

NY

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

N

LastModifiedDate

07/10/2023