MARIE-ELLEN TUBAL SARVIDA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****69

License Status

ACTIVE

Business

First Name

MARIE-ELLEN

Middle

TUBAL

Last Name

SARVIDA

Suffix

Business Name

MARIE-ELLEN TUBAL SARVIDA MD

Original Issue Date

07/28/2008

Effective Date

06/07/2023

Expiration Date

07/31/2026

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/07/2023