EDWIN BERT MILLER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036037128

License Status

NOT RENEWED

Business

First Name

EDWIN BERT

Last Name

MILLER

Suffix

Business Name

EDWIN BERT MILLER MD

Original Issue Date

03/02/1961

Effective Date

06/25/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60707

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017

Case Number

2014008028

Action

Permanent Inactive

Discipline Start Date

02/13/2017

Discipline Reason

for not submitting proof of completion of CMEs by April 23, 2016, as required pursuant to a prior agreement.