MARA S TACHE Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****29

License Status

NOT RENEWED

Business

First Name

MARA

Middle

Last Name

TACHE

Business Name

MARA S TACHE

Original Issue Date

06/15/2000

Effective Date

06/15/2000

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60614

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006