DEREK JONATHAN KOLLER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036151000

License Status

ACTIVE

Business

Title

First Name

DEREK

Middle

JONATHAN

Last Name

KOLLER

Business Name

DEREK JONATHAN KOLLER MD

Original Issue Date

10/11/2019

Effective Date

07/31/2023

Expiration Date

07/31/2026

City

SALEM

State

Zip

97306

Ever Disciplined

LastModifiedDate

09/24/2023