TARA KOTAGAL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

ACTIVE

Business

Title

First Name

TARA

Last Name

KOTAGAL

Business Name

TARA KOTAGAL MD

Original Issue Date

05/18/2020

Effective Date

04/29/2023

Expiration Date

07/31/2026

City

SKOKIE

State

Zip

60076

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/29/2023