DERISSA FOLASADE RAYNOLD MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING RESIDENT

License Number

188001070

License Status

EXPIRED

Business

Title

First Name

DERISSA

Middle

FOLASADE

Last Name

RAYNOLD

Business Name

DERISSA FOLASADE RAYNOLD MD

Original Issue Date

07/01/2024

Effective Date

07/01/2024

Expiration Date

12/31/2024

City

PEORIA

State

Zip

61605

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

10/29/2025