TARA OLIVE HENDERSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****22

License Status

ACTIVE

Business

First Name

TARA

Middle

OLIVE

Last Name

HENDERSON

Suffix

Business Name

TARA OLIVE HENDERSON MD

Original Issue Date

08/15/2005

Effective Date

07/22/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/22/2023