BUTCH BACLIG TUBERA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

NOT RENEWED

Business

First Name

BUTCH

Middle

BACLIG

Last Name

TUBERA

Suffix

Business Name

BUTCH BACLIG TUBERA MD

Original Issue Date

11/05/1999

Effective Date

11/05/1999

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60616

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011