TIMOTHY S TAYLOR Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****80

License Status

NOT RENEWED

Business

First Name

TIMOTHY S

Last Name

TAYLOR

Business Name

TIMOTHY S TAYLOR

Original Issue Date

01/17/1991

Effective Date

01/17/1991

Expiration Date

09/30/1994

City

BARTONVILLE

State

Zip

61607

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005