AMY J DERICK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

ACTIVE

Business

First Name

AMY

Middle

Last Name

DERICK

Suffix

Business Name

AMY J DERICK MD

Original Issue Date

07/07/2021

Effective Date

06/14/2023

Expiration Date

07/31/2026

City

BURR RIDGE

State

Zip

60527

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/14/2023