MARIA MIKAELA PETRICK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036107594

License Status

NOT RENEWED

Business

First Name

MARIA

Middle

MIKAELA

Last Name

PETRICK

Suffix

Business Name

MARIA MIKAELA PETRICK MD

Original Issue Date

08/01/2002

Effective Date

08/01/2002

Expiration Date

07/31/2005

City

SWANSEA

State

Zip

62226

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

01/10/2007