STEPHANIE E TATE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****90

License Status

ACTIVE

Business

First Name

STEPHANIE E

Last Name

TATE

Suffix

Business Name

STEPHANIE E TATE MD

Original Issue Date

10/24/1988

Effective Date

06/07/2023

Expiration Date

07/31/2026

City

BLOOMINGTON

State

Zip

61702

County

MCLEAN

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

06/07/2023