AMELIA JEAN DERSTINE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125070654

License Status

EXPIRED

Business

Title

First Name

AMELIA

Middle

JEAN

Last Name

DERSTINE

Business Name

AMELIA JEAN DERSTINE MD

Original Issue Date

06/24/2017

Effective Date

06/24/2017

Expiration Date

06/23/2020

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

11/19/2020