BRIAN MICHAEL DERBY MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052759

License Status

EXPIRED

Business

First Name

BRIAN

Middle

MICHAEL

Last Name

DERBY

Suffix

Business Name

BRIAN MICHAEL DERBY MD

Original Issue Date

07/01/2010

Effective Date

07/01/2010

Expiration Date

06/30/2013

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Plastic Surgery

Ever Disciplined

LastModifiedDate

10/07/2013