DAMON MARCUS DERTINA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****35

License Status

NOT RENEWED

Business

First Name

DAMON

Middle

MARCUS

Last Name

DERTINA

Suffix

Business Name

DAMON MARCUS DERTINA MD

Original Issue Date

09/15/2006

Effective Date

09/15/2006

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008