ROSS TANIS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074811

License Status

CANCELLED

Business

Title

First Name

ROSS

Last Name

TANIS

Business Name

ROSS TANIS MD

Original Issue Date

06/22/2019

Effective Date

06/22/2019

Expiration Date

06/21/2022

City

HINSDALE

State

Zip

60521

County

DUPAGE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

04/23/2019