MARTA TABAKA Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****77

License Status

NOT RENEWED

Business

First Name

MARTA

Last Name

TABAKA

Business Name

MARTA TABAKA

Original Issue Date

01/29/2008

Effective Date

01/29/2008

Expiration Date

03/01/2010

City

CHICAGO

State

Zip

60608

County

COOK

Ever Disciplined

LastModifiedDate

08/18/2008