TANYA R GREEN Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****78

License Status

ACTIVE

Business

First Name

TANYA

Middle

Last Name

GREEN

Business Name

TANYA R GREEN

Original Issue Date

06/20/2018

Effective Date

02/23/2026

Expiration Date

03/01/2028

City

BELLEVILLE

State

Zip

62226

County

SAINT CLAIR

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/23/2026