GLENN ANTHONY A TAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

ACTIVE

Business

First Name

GLENN ANTHONY

Middle

Last Name

TAN

Suffix

Business Name

GLENN ANTHONY A TAN MD

Original Issue Date

01/15/2008

Effective Date

06/22/2023

Expiration Date

07/31/2026

City

ROSCOE

State

Zip

61073

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/22/2023