ROGER P TATUM Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

NOT RENEWED

Business

First Name

ROGER

Middle

Last Name

TATUM

Business Name

ROGER P TATUM

Original Issue Date

04/29/1998

Effective Date

04/29/1998

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/26/2006