C TYSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

ACTIVE

Business

First Name

Last Name

TYSON

Suffix

Business Name

C TYSON MD

Original Issue Date

07/02/1986

Effective Date

07/18/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60617

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/18/2023