ADAM DAVID DERHAKE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

ACTIVE

Business

First Name

ADAM

Middle

DAVID

Last Name

DERHAKE

Suffix

Business Name

ADAM DAVID DERHAKE MD

Original Issue Date

12/11/2008

Effective Date

04/19/2023

Expiration Date

07/31/2026

City

QUINCY

State

Zip

62301

County

ADAMS

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/19/2023