TANNER CRAIG EIBEN DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125073359

License Status

CANCELLED

Business

Title

First Name

TANNER

Middle

CRAIG

Last Name

EIBEN

Business Name

TANNER CRAIG EIBEN DO

Original Issue Date

07/01/2021

Effective Date

07/01/2021

Expiration Date

06/30/2022

City

QUINCY

State

Zip

62301

County

ADAMS

Specialty/Qualifier

Sports Medicine (Family Practice)

Ever Disciplined

LastModifiedDate

04/21/2021