TEAH QVAVADZE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****15

License Status

ACTIVE

Business

Title

First Name

TEAH

Last Name

QVAVADZE

Business Name

TEAH QVAVADZE MD

Original Issue Date

08/31/2023

Effective Date

08/31/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62702

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/31/2023