MARK WALLACE TAYLOR Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125027865

License Status

EXPIRED

Business

First Name

MARK WALLACE

Last Name

TAYLOR

Business Name

MARK WALLACE TAYLOR

Original Issue Date

05/04/1992

Effective Date

05/04/1992

Expiration Date

06/21/1996

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Ophthalmology

Ever Disciplined

LastModifiedDate

09/22/2006