MARVIN JAMES DERRICK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

ACTIVE

Business

First Name

MARVIN

Middle

JAMES

Last Name

DERRICK

Suffix

Business Name

MARVIN JAMES DERRICK MD

Original Issue Date

06/12/2009

Effective Date

06/05/2023

Expiration Date

07/31/2026

City

NORMAL

State

Zip

61761

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/30/2023