JAY EDWIN TALLIS OD Optometrist License verification

Business Entity

ACTIVE

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****58

License Status

ACTIVE

Business

First Name

JAY

Middle

EDWIN

Last Name

TALLIS

Suffix

Business Name

JAY EDWIN TALLIS OD

Original Issue Date

05/13/1998

Effective Date

01/30/2024

Expiration Date

03/31/2026

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/08/2026