TIFFANY LEE ANTHONY 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

TIFFANY

Middle

LEE

Last Name

ANTHONY

Suffix

Business Name

TIFFANY LEE ANTHONY MD

Original Issue Date

05/22/2006

Effective Date

05/22/2006

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008