TARA MEHTA JAIN Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****71

License Status

ACTIVE

Business

First Name

TARA

Middle

MEHTA

Last Name

JAIN

Business Name

TARA MEHTA JAIN

Original Issue Date

01/29/2010

Effective Date

12/07/2025

Expiration Date

03/01/2028

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/07/2025