ADAM DAVID DERHAKE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125046367

License Status

EXPIRED

Business

First Name

ADAM

Middle

DAVID

Last Name

DERHAKE

Suffix

Business Name

ADAM DAVID DERHAKE MD

Original Issue Date

06/24/2003

Effective Date

06/24/2003

Expiration Date

06/23/2008

City

QUINCY

State

Zip

62301

Specialty/Qualifier

Orthopaedic Surgery

Ever Disciplined

LastModifiedDate

06/26/2008