ALISA MARIA TAYLOR DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****24

License Status

NOT RENEWED

Business

First Name

ALISA

Middle

MARIA

Last Name

TAYLOR

Suffix

DMD

Business Name

ALISA MARIA TAYLOR DMD

Original Issue Date

08/17/2006

Effective Date

09/27/2021

Expiration Date

09/30/2024

City

MATTOON

State

Zip

61938

County

COLES

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025