ELY R TANDETER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****45

License Status

ACTIVE

Business

First Name

ELY R

Last Name

TANDETER

Suffix

Business Name

ELY R TANDETER MD

Original Issue Date

03/22/1982

Effective Date

05/25/2023

Expiration Date

07/31/2026

City

WILMETTE

State

Zip

60091

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/25/2023