DEREK O'NEIL STOUT DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125041602

License Status

EXPIRED

Business

First Name

DEREK

Middle

O'NEIL

Last Name

STOUT

Suffix

Business Name

DEREK O'NEIL STOUT DO

Original Issue Date

06/20/2000

Effective Date

06/20/2000

Expiration Date

06/19/2003

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006