DAVID J DERITA Clinical Psychologist License verification

Business Entity

NOT RENEWED

License Type

Clinical Psychologist

Description

CLINICAL PSYCHOLOGIST

License Number

071002434

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

Last Name

DERITA

Business Name

DAVID J DERITA

Original Issue Date

09/25/1978

Effective Date

09/24/2014

Expiration Date

09/30/2016

City

TOWER LAKES

State

Zip

60010

County

LAKE

Ever Disciplined

LastModifiedDate

11/26/2016