JEFFERSON TIU LOA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

NOT RENEWED

Business

Title

First Name

JEFFERSON

Middle

TIU

Last Name

LOA

Business Name

JEFFERSON TIU LOA MD

Original Issue Date

07/19/2010

Effective Date

07/28/2014

Expiration Date

07/31/2017

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017