DERRICK B TARTT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

NOT RENEWED

Business

First Name

DERRICK B

Last Name

TARTT

Suffix

Business Name

DERRICK B TARTT MD

Original Issue Date

08/05/2008

Effective Date

08/05/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60643

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

11/10/2011