DERICK RENE DUVIVIER MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125038254

License Status

EXPIRED

Business

First Name

DERICK

Middle

RENE

Last Name

DUVIVIER

Suffix

Business Name

DERICK RENE DUVIVIER MD

Original Issue Date

06/24/1998

Effective Date

06/24/1998

Expiration Date

06/23/1999

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006