KELLY SHAWN DERBIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036103583

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

SHAWN

Last Name

DERBIN

Suffix

Business Name

KELLY SHAWN DERBIN MD

Original Issue Date

10/02/2000

Effective Date

10/02/2000

Expiration Date

07/31/2005

City

OAK PARK

State

Zip

60302

County

COOK

Ever Disciplined

LastModifiedDate

06/02/2008