TAIS V CRAWFORD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****84

License Status

ACTIVE

Business

First Name

TAIS

Middle

Last Name

CRAWFORD

Business Name

TAIS V CRAWFORD

Original Issue Date

08/04/1999

Effective Date

07/31/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60653

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/31/2023