PAUL ELLIS TATUM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

ACTIVE

Business

Title

First Name

PAUL

Middle

ELLIS

Last Name

TATUM

Business Name

PAUL ELLIS TATUM MD

Original Issue Date

07/15/2022

Effective Date

06/16/2023

Expiration Date

07/31/2026

City

SAINT LOUIS

State

Zip

63106

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/16/2023