TAMARA R FOUNTAIN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036085597

License Status

ACTIVE

Business

First Name

TAMARA

Middle

Last Name

FOUNTAIN

Suffix

Business Name

TAMARA R FOUNTAIN MD

Original Issue Date

11/06/1992

Effective Date

04/20/2023

Expiration Date

07/31/2026

City

DEERFIELD

State

Zip

60015

County

LAKE

Ever Disciplined

LastModifiedDate

04/20/2023