BRIAN VAN TINE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****18

License Status

ACTIVE

Business

Title

First Name

BRIAN

Last Name

VAN TINE

Business Name

BRIAN VAN TINE MD

Original Issue Date

08/24/2020

Effective Date

04/12/2023

Expiration Date

07/31/2026

City

SAINT LOUIS

State

Zip

63110

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2023