VAUGHN DERRELL TATUM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

NOT RENEWED

Business

First Name

VAUGHN

Middle

DERRELL

Last Name

TATUM

Suffix

Business Name

VAUGHN DERRELL TATUM MD

Original Issue Date

07/22/1993

Effective Date

07/23/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020