TAMARA S HEIBULT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****16

License Status

NOT RENEWED

Business

Title

First Name

TAMARA

Middle

Last Name

HEIBULT

Business Name

TAMARA S HEIBULT MD

Original Issue Date

09/04/2014

Effective Date

09/04/2014

Expiration Date

07/31/2017

City

JOLIET

State

Zip

60435

County

WILL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020