VENITA R EDWARDS TALLEY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****25

License Status

NOT RENEWED

Business

First Name

VENITA R EDWARDS

Last Name

TALLEY

Suffix

Business Name

VENITA R EDWARDS TALLEY MD

Original Issue Date

10/14/1986

Effective Date

06/10/2020

Expiration Date

07/31/2023

City

HINES

State

Zip

60141

County

MACON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023