MARY W TIBBETTS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

NOT RENEWED

Business

First Name

MARY

Middle

Last Name

TIBBETTS

Business Name

MARY W TIBBETTS

Original Issue Date

02/28/2000

Effective Date

02/28/2000

Expiration Date

07/31/2005

City

MORTON GROVE

State

Zip

60053

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006