TARA KATHERINE SUNTUM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

NOT RENEWED

Business

Title

First Name

TARA

Middle

KATHERINE

Last Name

SUNTUM

Business Name

TARA KATHERINE SUNTUM MD

Original Issue Date

02/02/2017

Effective Date

06/14/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021