TARA A BROCKMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036159960

License Status

NOT RENEWED

Business

Title

First Name

TARA

Middle

Last Name

BROCKMAN

Business Name

TARA A BROCKMAN MD

Original Issue Date

03/26/2022

Effective Date

03/26/2022

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60642

Ever Disciplined

LastModifiedDate

11/30/2023