CHRIS TARA BULAON DELOS REYES MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****95

License Status

ACTIVE

Business

Title

First Name

CHRIS

Middle

TARA BULAON

Last Name

DELOS REYES

Business Name

CHRIS TARA BULAON DELOS REYES MD

Original Issue Date

04/30/2012

Effective Date

06/03/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60654

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/03/2023