TANIKA VALEA MARTIN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****40

License Status

NOT RENEWED

Business

First Name

TANIKA

Middle

VALEA

Last Name

MARTIN

Business Name

TANIKA VALEA MARTIN

Original Issue Date

01/22/2022

Effective Date

02/01/2022

Expiration Date

03/01/2024

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025