SHAMANT TIPPOR 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

First Name

SHAMANT

Last Name

TIPPOR

Suffix

Business Name

SHAMANT TIPPOR MD

Original Issue Date

04/08/2009

Effective Date

04/08/2009

Expiration Date

07/31/2011

City

NORMAL

State

Zip

61761

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011