TYEESE LATEEFA GAINES DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036142056

License Status

ACTIVE

Business

Title

First Name

TYEESE

Middle

LATEEFA

Last Name

GAINES

Business Name

TYEESE LATEEFA GAINES DO

Original Issue Date

12/02/2016

Effective Date

07/10/2023

Expiration Date

07/31/2026

City

JERSEY CITY

State

Zip

07305

Ever Disciplined

LastModifiedDate

07/10/2023