DERREK S DAVIS Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****28

License Status

ACTIVE

Business

First Name

DERREK S

Last Name

DAVIS

Business Name

DERREK S DAVIS

Original Issue Date

07/31/1997

Effective Date

04/18/2023

Expiration Date

07/31/2026

City

DOWNERS GROVE

State

Zip

60516

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/18/2023