MICHAEL D ANDERSEN - Medical Doctor License in Illinois | # 125029696

MICHAEL D ANDERSEN

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125029696

License Status

EXPIRED

Business

N

First Name

MICHAEL D

Last Name

ANDERSEN

Business Name

MICHAEL D ANDERSEN

Original Issue Date

05/17/1993

Effective Date

05/17/1993

Expiration Date

06/21/1996

State

IL

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

N

LastModifiedDate

09/22/2006