TIA JAVANTE DORN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125064108

License Status

CANCELLED

Business

First Name

TIA

Middle

JAVANTE

Last Name

DORN

Suffix

Business Name

TIA JAVANTE DORN MD

Original Issue Date

07/01/2013

Effective Date

07/01/2013

Expiration Date

06/30/2016

City

OAK PARK

State

Zip

60302

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/24/2014