TANNER M JOHANNS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****18

License Status

ACTIVE

Business

Title

First Name

TANNER

Middle

Last Name

JOHANNS

Business Name

TANNER M JOHANNS MD

Original Issue Date

12/07/2020

Effective Date

07/11/2023

Expiration Date

07/31/2026

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/11/2023