TARA ELAINE HUMPHREY DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036141571

License Status

NOT RENEWED

Business

Title

First Name

TARA

Middle

ELAINE

Last Name

HUMPHREY

Business Name

TARA ELAINE HUMPHREY DO

Original Issue Date

08/24/2016

Effective Date

08/24/2016

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60607

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017