ENRICO TAN Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****78

License Status

NOT RENEWED

Business

First Name

ENRICO

Last Name

TAN

Business Name

ENRICO TAN

Original Issue Date

10/01/1990

Effective Date

10/01/1990

Expiration Date

01/31/1993

City

SPRING VALLEY

State

Zip

61362

County

BUREAU

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/25/2006