DEREK MIKAEL SORENSEN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125051689

License Status

EXPIRED

Business

First Name

DEREK

Middle

MIKAEL

Last Name

SORENSEN

Business Name

DEREK MIKAEL SORENSEN

Original Issue Date

07/01/2006

Effective Date

07/01/2006

Expiration Date

06/30/2009

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

07/15/2009