BERNARDO O TAN JR Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****07

License Status

NOT RENEWED

Business

First Name

BERNARDO O

Last Name

TAN JR

Business Name

BERNARDO O TAN JR

Original Issue Date

11/25/1996

Effective Date

11/25/1996

Expiration Date

07/31/2008

City

GURNEE

State

Zip

60031

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008