DERRALYN M. HARRIS, M.D Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125038698

License Status

EXPIRED

Business

First Name

DERRALYN

Middle

Last Name

HARRIS,

Suffix

M.D

Business Name

DERRALYN M. HARRIS, M.D

Original Issue Date

07/01/1998

Effective Date

07/01/1998

Expiration Date

06/30/2001

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006