LISA F DERKEN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125033435

License Status

EXPIRED

Business

First Name

LISA F

Last Name

DERKEN

Business Name

LISA F DERKEN

Original Issue Date

06/17/1995

Effective Date

06/17/1995

Expiration Date

06/30/1998

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006