DAMON MARCUS DERTINA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036114722

License Status

NOT RENEWED

Business

First Name

DAMON

Middle

MARCUS

Last Name

DERTINA

Suffix

Business Name

DAMON MARCUS DERTINA MD

Original Issue Date

10/11/2005

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60610

County

COOK

Ever Disciplined

LastModifiedDate

11/06/2008