KENNETH CRAIG MICETICH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036056032

License Status

ACTIVE

Business

First Name

KENNETH

Middle

CRAIG

Last Name

MICETICH

Suffix

Business Name

KENNETH CRAIG MICETICH MD

Original Issue Date

11/14/1977

Effective Date

06/07/2023

Expiration Date

07/31/2026

City

BURR RIDGE

State

Zip

60527

County

DUPAGE

Ever Disciplined

LastModifiedDate

06/07/2023