DEREK SEAN BUMGARNER MD - Medical Doctor License in Illinois | # 125062985

DEREK SEAN BUMGARNER MD

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062985

License Status

CANCELLED

Business

N

Title

MD

First Name

DEREK

Middle

SEAN

Last Name

BUMGARNER

Business Name

DEREK SEAN BUMGARNER MD

Original Issue Date

07/01/2013

Effective Date

07/01/2013

Expiration Date

06/30/2016

State

IL

Specialty/Qualifier

Pathology

Ever Disciplined

N

LastModifiedDate

03/24/2014