PRISCILLA ROCHE MUTHARASAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

NOT RENEWED

Business

Title

First Name

PRISCILLA

Middle

ROCHE

Last Name

MUTHARASAN

Business Name

PRISCILLA ROCHE MUTHARASAN MD

Original Issue Date

10/21/2010

Effective Date

05/16/2011

Expiration Date

07/31/2014

City

OAK PARK

State

Zip

60302

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/03/2021