DERRICK B TARTT MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****69

NOT RENEWED

N

DERRICK B

TARTT

MD

DERRICK B TARTT MD

12/23/1991

07/30/2008

07/31/2011

CHICAGO

IL

60707

COOK

II III IV V

N

11/10/2011