DEREK SEAN BUMGARNER MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062985

License Status

CANCELLED

Business

Title

First Name

DEREK

Middle

SEAN

Last Name

BUMGARNER

Business Name

DEREK SEAN BUMGARNER MD

Original Issue Date

07/01/2013

Effective Date

07/01/2013

Expiration Date

06/30/2016

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Pathology

Ever Disciplined

LastModifiedDate

03/24/2014