TONY B BORBOA JR Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

CANCELLED

Business

First Name

TONY

Middle

Last Name

BORBOA JR

Business Name

TONY B BORBOA JR

Original Issue Date

12/02/2004

Effective Date

12/02/2004

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60649

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006