MADELINE EMELIA TENNANT Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****93

License Status

INOPERATIVE

Business

First Name

MADELINE

Middle

EMELIA

Last Name

TENNANT

Business Name

MADELINE EMELIA TENNANT

Original Issue Date

07/11/2018

Effective Date

01/07/2022

Expiration Date

03/01/2024

City

ARLINGTON HEIGHTS

State

Zip

60005

County

COOK

Ever Disciplined

LastModifiedDate

12/06/2023