Indiana
Professional Licensing Agency
Derrick William Dvorak
Temporary Medical Doctor Permit
License number
99042489A
Date granted
05/26/2010
Date expires
08/26/2010
Class
Temporary Medical Doctor Permit
Status
Superceded
Address
Fort Wayne IN 46804
indianalicensing.org
ID 6131129
LAST UPDATED 2026-04-10 07:27:47 UTC
LAST UPDATED 2026-04-10 07:27:47 UTC
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