ROBERT NICHOLAS TIBALLI DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****61

License Status

NOT RENEWED

Business

Title

First Name

ROBERT

Middle

NICHOLAS

Last Name

TIBALLI

Business Name

ROBERT NICHOLAS TIBALLI DO

Original Issue Date

07/31/1995

Effective Date

07/31/1995

Expiration Date

07/31/1999

City

ELGIN

State

Zip

60123

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020