DERRALD G TAYLOR Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****18

License Status

NOT RENEWED

Business

First Name

DERRALD G

Last Name

TAYLOR

Business Name

DERRALD G TAYLOR

Original Issue Date

03/20/1997

Effective Date

03/20/2018

Expiration Date

09/30/2020

City

MOKENA

State

Zip

60448

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/14/2021