DERRALD G TAYLOR Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047006305

License Status

CANCELLED

Business

First Name

DERRALD G

Last Name

TAYLOR

Business Name

DERRALD G TAYLOR

Original Issue Date

09/16/1972

Expiration Date

01/01/1997

City

MIDLOTHIAN

State

Zip

60445

County

COOK

Ever Disciplined

LastModifiedDate

09/01/2005