TIA JAVANTE DORN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****38

License Status

NOT RENEWED

Business

First Name

TIA

Middle

JAVANTE

Last Name

DORN

Suffix

Business Name

TIA JAVANTE DORN MD

Original Issue Date

03/26/2018

Effective Date

03/26/2018

Expiration Date

09/30/2020

City

OAK PARK

State

Zip

60302

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021