JEFFREY S TENNANT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

NOT RENEWED

Business

First Name

JEFFREY S

Last Name

TENNANT

Suffix

Business Name

JEFFREY S TENNANT MD

Original Issue Date

01/01/1997

Effective Date

06/28/2017

Expiration Date

09/30/2020

City

PEKIN

State

Zip

61554

County

TAZEWELL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021