THOMAS A MIKKELSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036057027

License Status

NOT RENEWED

Business

First Name

THOMAS

Middle

Last Name

MIKKELSON

Suffix

Business Name

THOMAS A MIKKELSON MD

Original Issue Date

07/13/1978

Effective Date

06/26/2017

Expiration Date

09/30/2020

City

LEBANON

State

Zip

62254

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

01/14/2021