| | Physician Last Name: | Iacono |
| | Physician First Name: | Tara |
| | Physician Middle Name: | M |
| | Address: | 240 Patchogue Yaphank Road
Suite 211
Patchogue, NY 11772 |
| | License Number: | 012592 |
| | License Type: | PA |
| | Year of Birth: |
1983
|
| | Effective Date: | 04/09/2013 |
| | Action Description for DOH Webpage: | The physician's assistant's stayed license suspension is terminated and her probation is terminated effective April 9, 2013. |
| | Misconduct Description for DOH Webpage: | This order is a modification of the terms previously imposed on November 4, 2010 and does not constitute a new disciplinary action. Previously the physician assistant did not contest the charge of having been disciplined by the Massachusetts State Board of Registration of Physician Assistants for gross misconduct and practicing without the required physician supervision. |
| | License Limitations or Conditions for DOH Webpage: | |
| | Board Order: |
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