JOSE PEREZ TAMAYO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****34

License Status

NOT RENEWED

Business

First Name

JOSE PEREZ

Last Name

TAMAYO

Business Name

JOSE PEREZ TAMAYO

Original Issue Date

07/02/1996

Effective Date

05/18/2011

Expiration Date

07/31/2014

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2014