MICHAEL G DOUGLAS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036090782

License Status

NOT RENEWED

Business

First Name

MICHAEL G

Last Name

DOUGLAS

Business Name

MICHAEL G DOUGLAS

Original Issue Date

05/31/1995

Effective Date

05/31/1995

Expiration Date

07/31/1999

City

SPRINGFIELD

State

Zip

62707

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/20/2006