JAMES F TACKETT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

NOT RENEWED

Business

Title

First Name

JAMES

Middle

Last Name

TACKETT

Business Name

JAMES F TACKETT MD

Original Issue Date

11/09/2006

Effective Date

06/26/2008

Expiration Date

07/31/2011

City

PEORIA

State

Zip

61636

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011