TISCHELLE KENYETTA GATLIN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

ACTIVE

Business

Title

First Name

TISCHELLE

Middle

KENYETTA

Last Name

GATLIN

Business Name

TISCHELLE KENYETTA GATLIN MD

Original Issue Date

03/05/2021

Effective Date

06/16/2023

Expiration Date

07/31/2026

City

MAYWOOD

State

Zip

60153

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/16/2023