TARA SUZANNE FOX DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****11

License Status

NOT RENEWED

Business

First Name

TARA

Middle

SUZANNE

Last Name

FOX

Suffix

DPM

Business Name

TARA SUZANNE FOX DPM

Original Issue Date

07/20/2006

Effective Date

02/04/2019

Expiration Date

01/31/2021

City

LINCOLNWOOD

State

Zip

60712

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/11/2021