VAUGHN DERRELL TATUM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036056693

License Status

NOT RENEWED

Business

First Name

VAUGHN

Middle

DERRELL

Last Name

TATUM

Suffix

Business Name

VAUGHN DERRELL TATUM MD

Original Issue Date

04/17/1978

Effective Date

08/02/2017

Expiration Date

09/30/2020

City

WHEATON

State

Zip

60187

County

COOK

Ever Disciplined

LastModifiedDate

01/14/2021

Case Number

1992006690

Action

Probation

Discipline Start Date

06/23/1994

Discipline End Date

10/06/2006

Discipline Reason

Failing to file certain state income tax returns.