DAVID DALE VANDERKIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

DALE

Last Name

VANDERKIN

Suffix

Business Name

DAVID DALE VANDERKIN MD

Original Issue Date

07/07/2004

Effective Date

07/24/2017

Expiration Date

09/30/2020

City

FRANKFORT

State

Zip

60423

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021