ANDREA GAIL TENNER MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****67

License Status

CANCELLED

Business

First Name

ANDREA

Middle

GAIL

Last Name

TENNER

Suffix

Business Name

ANDREA GAIL TENNER MD

Original Issue Date

11/27/2007

Effective Date

06/03/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011