SEAN P TIERNEY Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****03

License Status

NOT RENEWED

Business

First Name

SEAN P

Last Name

TIERNEY

Business Name

SEAN P TIERNEY

Original Issue Date

06/18/2004

Effective Date

06/18/2004

Expiration Date

07/31/2008

City

MERRIONETTE PARK

State

Zip

60803

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020