DAVID EDWARD TENNANT MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****20

License Status

ACTIVE

Business

Title

First Name

DAVID

Middle

EDWARD

Last Name

TENNANT

Business Name

DAVID EDWARD TENNANT MD

Original Issue Date

08/11/2017

Effective Date

04/09/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61636

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/09/2023