TIFFANY A CUMMINS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****43

License Status

NOT RENEWED

Business

First Name

TIFFANY

Middle

Last Name

CUMMINS

Business Name

TIFFANY A CUMMINS

Original Issue Date

07/10/2003

Effective Date

07/10/2003

Expiration Date

07/31/2005

City

MCHENRY

State

Zip

60050

County

MCHENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006