ADAM C TIAGONCE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

ACTIVE

Business

Title

First Name

ADAM

Middle

Last Name

TIAGONCE

Business Name

ADAM C TIAGONCE MD

Original Issue Date

06/02/2020

Effective Date

06/09/2023

Expiration Date

07/31/2026

City

PARK RIDGE

State

Zip

60068

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/09/2023