TARA KOTAGAL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125069943

License Status

CANCELLED

Business

Title

First Name

TARA

Last Name

KOTAGAL

Business Name

TARA KOTAGAL MD

Original Issue Date

06/24/2017

Effective Date

06/24/2017

Expiration Date

06/23/2020

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

04/27/2017