DERYK SPENCER ANDERSON DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

NOT RENEWED

Business

Title

First Name

DERYK

Middle

SPENCER

Last Name

ANDERSON

Business Name

DERYK SPENCER ANDERSON DO

Original Issue Date

05/07/2010

Effective Date

07/25/2011

Expiration Date

07/31/2014

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

11/17/2014