TINA HALLER-WADE Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****98

License Status

ACTIVE

Business

First Name

TINA

Last Name

HALLER-WADE

Business Name

TINA HALLER-WADE

Original Issue Date

07/15/2008

Effective Date

05/10/2023

Expiration Date

07/31/2026

City

BELVIDERE

State

Zip

61008

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/10/2023