ANITA MARIE TILLMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****28

License Status

NOT RENEWED

Business

First Name

ANITA

Middle

MARIE

Last Name

TILLMAN

Suffix

Business Name

ANITA MARIE TILLMAN MD

Original Issue Date

06/16/1992

Effective Date

06/16/1992

Expiration Date

07/31/1996

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020