DEREK VINCENT BOOTON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****16

License Status

NOT RENEWED

Business

First Name

DEREK

Middle

VINCENT

Last Name

BOOTON

Suffix

Business Name

DEREK VINCENT BOOTON MD

Original Issue Date

07/05/2000

Effective Date

06/26/2017

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62781

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021