BETH A MIKKELSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036069260

License Status

NOT RENEWED

Business

First Name

BETH A

Last Name

MIKKELSEN

Suffix

Business Name

BETH A MIKKELSEN MD

Original Issue Date

08/09/1984

Effective Date

08/09/1984

Expiration Date

07/31/1987

City

STREAMWOOD

State

Zip

60103

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006