SHADI LATTA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****20

License Status

ACTIVE

Business

First Name

SHADI

Last Name

LATTA

Suffix

Business Name

SHADI LATTA MD

Original Issue Date

09/22/2008

Effective Date

07/13/2023

Expiration Date

07/31/2026

City

ORLAND PARK

State

Zip

60462

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/13/2023