DANILO TIU TAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

NOT RENEWED

Business

First Name

DANILO

Middle

TIU

Last Name

TAN

Suffix

Business Name

DANILO TIU TAN MD

Original Issue Date

08/19/1999

Effective Date

08/19/1999

Expiration Date

07/31/2005

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020