MICHAEL S IP MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036101117

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

Last Name

Suffix

Business Name

MICHAEL S IP MD

Original Issue Date

08/25/1999

Effective Date

06/12/2014

Expiration Date

07/31/2017

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

11/01/2017