DEREK SEAN BUMGARNER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036138853

License Status

NOT RENEWED

Business

Title

First Name

DEREK

Middle

SEAN

Last Name

BUMGARNER

Business Name

DEREK SEAN BUMGARNER MD

Original Issue Date

08/04/2015

Effective Date

04/25/2017

Expiration Date

09/30/2020

City

MONTGOMERY

State

Zip

60538

County

KENDALL

Ever Disciplined

LastModifiedDate

01/14/2021