TIA LATEEFAH JACKSON-BEY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****37

License Status

NOT RENEWED

Business

Title

First Name

TIA

Middle

LATEEFAH

Last Name

JACKSON-BEY

Business Name

TIA LATEEFAH JACKSON-BEY MD

Original Issue Date

05/02/2017

Effective Date

05/02/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021