TANIA STAVREVA BALABANOVA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

ACTIVE

Business

First Name

TANIA

Middle

STAVREVA

Last Name

BALABANOVA

Suffix

Business Name

TANIA STAVREVA BALABANOVA MD

Original Issue Date

11/03/2010

Effective Date

07/03/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60631

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2023