SUMRA AHMED TAYEBALY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****27

License Status

NOT RENEWED

Business

Title

First Name

SUMRA

Middle

AHMED

Last Name

TAYEBALY

Business Name

SUMRA AHMED TAYEBALY MD

Original Issue Date

07/11/2018

Effective Date

05/26/2020

Expiration Date

07/31/2023

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023