AMI TALATI HANNAM Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

ACTIVE

Business

First Name

AMI

Middle

TALATI

Last Name

HANNAM

Business Name

AMI TALATI HANNAM

Original Issue Date

05/04/2007

Effective Date

06/10/2023

Expiration Date

07/31/2026

City

ORLAND PARK

State

Zip

60467

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/10/2023