License Directory

Tara Nicole Van De Wyngaerde Od

Active

Illinois license 34*****64

License

Licensed by
Illinois Department of Financial and Professional Regulation
License number
34*****64
Status
Active
First issued
June 25, 2007
Expires
March 31, 2028
License holder
Tara Nicole Van De Wyngaerde Od
Entity type
Individual

Classifications

More from the license record

Specialty
Hospital/Clinic
Controlled substance schedules
III IV V
Current term began
02/04/2026

Other Illinois licenses under this name

Contact

Mendota, IL 61342
La Salle County