DERRALD G TAYLOR Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****93

License Status

NOT RENEWED

Business

First Name

DERRALD G

Last Name

TAYLOR

Business Name

DERRALD G TAYLOR

Original Issue Date

04/09/1997

Effective Date

01/12/2000

Expiration Date

03/31/1998

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006