SHOICHIRO ALBERTO TANAKA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****61

License Status

ACTIVE

Business

Title

First Name

SHOICHIRO

Middle

ALBERTO

Last Name

TANAKA

Business Name

SHOICHIRO ALBERTO TANAKA MD

Original Issue Date

05/12/2021

Effective Date

07/25/2023

Expiration Date

07/31/2026

City

ALTON

State

Zip

62002

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/25/2023