VENITA R EDWARDS TALLEY MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125017746

License Status

EXPIRED

Business

First Name

VENITA R EDWARDS

Last Name

TALLEY

Suffix

Business Name

VENITA R EDWARDS TALLEY MD

Original Issue Date

01/21/1985

Effective Date

01/21/1985

Expiration Date

01/01/1987

City

SPRINGFIELD

State

Zip

62708

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006