BENJAMIN R TAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****35

License Status

ACTIVE

Business

First Name

BENJAMIN

Middle

Last Name

TAN

Suffix

Business Name

BENJAMIN R TAN MD

Original Issue Date

11/22/1999

Effective Date

04/13/2023

Expiration Date

07/31/2026

City

SAINT LOUIS

State

Zip

63110

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/13/2023