FREDELITO B TIU Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****78

License Status

NOT RENEWED

Business

First Name

FREDELITO

Middle

Last Name

TIU

Business Name

FREDELITO B TIU

Original Issue Date

07/20/1994

Effective Date

07/05/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60607

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020