License holder summary

DOUGLAS ELLIS DERSTINE is a Medicine - Athletic Trainer licensed to practice in Pennsylvania. The address on file for DOUGLAS ELLIS DERSTINE is VOID PA 18969. This licensed professional license is not current. The license was granted 11/09/1987 and expired on 12/31/1998.

Pennsylvania

Department of State

DOUGLAS ELLIS DERSTINE
Medicine - Athletic Trainer
License number
RT000559B
Date granted
11/09/1987
Date expires
12/31/1998
Class
Medicine - Athletic Trainer
Status
Voided
Address
VOID PA 18969
palicensing.org
ID 16615884
LAST UPDATED 2024-03-09 06:12:57 UTC

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