TAYLOR DATTOLO Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085008217

License Status

ACTIVE

Business

First Name

TAYLOR

Last Name

DATTOLO

Business Name

TAYLOR DATTOLO

Original Issue Date

02/18/2021

Effective Date

02/09/2026

Expiration Date

03/01/2028

City

PLAINFIELD

State

Zip

60586

County

WILL

Ever Disciplined

LastModifiedDate

02/09/2026