TIN HLA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****14

License Status

NOT RENEWED

Business

First Name

TIN

Last Name

HLA

Suffix

Business Name

TIN HLA MD

Original Issue Date

05/16/1983

Effective Date

04/13/2011

Expiration Date

07/31/2014

City

TINLEY PARK

State

Zip

60477

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014