FLORIDA TABAQUE DY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036048693

License Status

NOT RENEWED

Business

Title

First Name

FLORIDA

Middle

TABAQUE

Last Name

Business Name

FLORIDA TABAQUE DY MD

Original Issue Date

02/05/1974

Effective Date

04/21/2014

Expiration Date

07/31/2017

City

NORTHBROOK

State

Zip

60062

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017