HIEDILIZA YAMZON TAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

NOT RENEWED

Business

Title

First Name

HIEDILIZA

Middle

YAMZON

Last Name

TAN

Business Name

HIEDILIZA YAMZON TAN MD

Original Issue Date

08/25/2015

Effective Date

08/25/2015

Expiration Date

07/31/2017

City

ELGIN

State

Zip

60123

County

KANE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020