DERICK LAMONT THOMAS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****44

License Status

NOT RENEWED

Business

First Name

DERICK

Middle

LAMONT

Last Name

THOMAS

Business Name

DERICK LAMONT THOMAS

Original Issue Date

09/20/2017

Effective Date

03/17/2022

Expiration Date

03/01/2024

City

PADUCAH

State

Zip

42003

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025