GRIFFIN DAVID TANENBAUM Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085008304

License Status

NOT RENEWED

Business

First Name

GRIFFIN

Middle

DAVID

Last Name

TANENBAUM

Business Name

GRIFFIN DAVID TANENBAUM

Original Issue Date

05/19/2021

Effective Date

01/04/2022

Expiration Date

03/01/2024

City

NIWOT

State

Zip

80503

Ever Disciplined

LastModifiedDate

02/05/2025