RYAN M TARANTOLA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****35

License Status

NOT RENEWED

Business

First Name

RYAN

Middle

Last Name

TARANTOLA

Suffix

Business Name

RYAN M TARANTOLA MD

Original Issue Date

05/18/2011

Effective Date

05/18/2011

Expiration Date

07/31/2014

City

BELLEVILLE

State

Zip

62220

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020