MANHARLAL KESHAVJI TANNA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

NOT RENEWED

Business

First Name

MANHARLAL

Middle

KESHAVJI

Last Name

TANNA

Suffix

Business Name

MANHARLAL KESHAVJI TANNA MD

Original Issue Date

10/09/1996

Effective Date

10/09/1996

Expiration Date

07/31/2008

City

ROCKTON

State

Zip

61072

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020