DERREK S DAVIS Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125031718

License Status

CANCELLED

Business

First Name

DERREK S

Last Name

DAVIS

Business Name

DERREK S DAVIS

Original Issue Date

06/07/1994

Effective Date

06/07/1994

Expiration Date

06/22/1998

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

09/22/2006