TAWANNA N KING MD 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

Title

First Name

TAWANNA

Middle

Last Name

KING

Business Name

TAWANNA N KING MD

Original Issue Date

03/18/2021

Effective Date

03/18/2021

Expiration Date

07/31/2023

City

MENARD

State

Zip

62259

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023