DOUGLAS P MICHAELSON Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****08

License Status

NOT RENEWED

Business

First Name

DOUGLAS

Middle

Last Name

MICHAELSON

Business Name

DOUGLAS P MICHAELSON

Original Issue Date

01/08/2014

Effective Date

03/29/2018

Expiration Date

09/30/2020

City

MONTGOMERY

State

Zip

60538

County

KENDALL

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021