GISELLE JOAN TAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****44

License Status

NOT RENEWED

Business

Title

First Name

GISELLE

Middle

JOAN

Last Name

TAN

Business Name

GISELLE JOAN TAN MD

Original Issue Date

08/01/2017

Effective Date

09/15/2020

Expiration Date

07/31/2023

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

11/30/2023