DERIC M PARK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036147170

License Status

ACTIVE

Business

Title

First Name

DERIC

Middle

Last Name

PARK

Business Name

DERIC M PARK MD

Original Issue Date

08/09/2018

Effective Date

05/26/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

05/26/2023