DEREK BEATTY DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125070071

License Status

CANCELLED

Business

Title

First Name

DEREK

Last Name

BEATTY

Business Name

DEREK BEATTY DO

Original Issue Date

07/01/2020

Effective Date

07/01/2020

Expiration Date

06/30/2022

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

03/20/2020