ALTA DEROO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036162079

License Status

ACTIVE

Business

Title

First Name

ALTA

Last Name

DEROO

Business Name

ALTA DEROO MD

Original Issue Date

08/18/2022

Effective Date

06/15/2023

Expiration Date

07/31/2026

City

CENTER CITY

State

Zip

55012

Ever Disciplined

LastModifiedDate

06/15/2023