DERRICK ALWYN FOX MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036150058

License Status

NOT RENEWED

Business

Title

First Name

DERRICK

Middle

ALWYN

Last Name

FOX

Business Name

DERRICK ALWYN FOX MD

Original Issue Date

07/01/2019

Effective Date

08/25/2020

Expiration Date

07/31/2023

City

BLOOMINGTON

State

Zip

61705

County

MCLEAN

Ever Disciplined

LastModifiedDate

11/30/2023