Information as of 07/21/2019

Last Updated by Licensee on 12/04/2018

Ismael Tamba - DO Full and Unrestricted
License#: 
Issue Date: 
2010-01565
08/20/2010
License Status: 
Renewal Date:
Active  
12/28/2019  
 Public Action: Yes
 See: Actions-Adverse & Administrative Tab
Licensee General Information
Active License
Reason CodeLicense NumberSubcategoryIssue DateExpire Date
 2010-01565 08/20/2010 
Inactive License
Active Supervisee
SuperviseeTypeStatusApproval Date
GRAY, ALICIA NPActive10/29/2015
KARR, CHRISTIANNA NPActive08/08/2017
KITCHEL, ALICIA NPActive10/29/2015
North Carolina Hospital Admitting Privileges
Holly Hill Hospital
Out of State Active/Inactive Licenses
Pennsylvania
Out of Country Active/Inactive Licenses
None Reported