TANYA MARIE POWELL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****87

License Status

ACTIVE

Business

First Name

TANYA

Middle

MARIE

Last Name

POWELL

Suffix

Business Name

TANYA MARIE POWELL MD

Original Issue Date

06/01/2004

Effective Date

06/06/2023

Expiration Date

07/31/2026

City

PARK RIDGE

State

Zip

60631

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/06/2023