MAHTAB TASHAKORI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

ACTIVE

Business

First Name

MAHTAB

Last Name

TASHAKORI

Suffix

Business Name

MAHTAB TASHAKORI MD

Original Issue Date

06/19/2006

Effective Date

04/17/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2023