TARA RAZMA STAFFORD Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****00

License Status

ACTIVE

Business

First Name

TARA

Middle

RAZMA

Last Name

STAFFORD

Business Name

TARA RAZMA STAFFORD

Original Issue Date

07/19/2023

Effective Date

01/19/2026

Expiration Date

03/01/2028

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/19/2026