FLORIDA TABAQUE DY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

NOT RENEWED

Business

Title

First Name

FLORIDA

Middle

TABAQUE

Last Name

Business Name

FLORIDA TABAQUE DY MD

Original Issue Date

04/06/1998

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

ARLINGTON HEIGHTS

State

Zip

60005

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017