TARA A DE JESUS Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

ACTIVE

Business

First Name

TARA

Middle

Last Name

DE JESUS

Business Name

TARA A DE JESUS

Original Issue Date

04/10/2003

Effective Date

06/29/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60623

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/29/2023