GRIFFIN DAVID TANENBAUM Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****60

License Status

NOT RENEWED

Business

First Name

GRIFFIN

Middle

DAVID

Last Name

TANENBAUM

Business Name

GRIFFIN DAVID TANENBAUM

Original Issue Date

07/24/2021

Effective Date

01/04/2022

Expiration Date

03/01/2024

City

MCHENRY

State

Zip

60050

County

MCHENRY

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025