ANN E TICE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****68

License Status

ACTIVE

Business

First Name

ANN E

Last Name

TICE

Suffix

Business Name

ANN E TICE MD

Original Issue Date

07/30/1982

Effective Date

04/09/2023

Expiration Date

07/31/2026

City

HOWELL

State

Zip

48843

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/09/2023