TIMOTHY S TAYLOR Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****78

License Status

NOT RENEWED

Business

First Name

TIMOTHY S

Last Name

TAYLOR

Business Name

TIMOTHY S TAYLOR

Original Issue Date

12/11/1990

Effective Date

12/11/1990

Expiration Date

09/30/1992

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005