JENNIFER J MICKELSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036117785

License Status

NOT RENEWED

Business

Title

First Name

JENNIFER

Middle

Last Name

MICKELSON

Business Name

JENNIFER J MICKELSON MD

Original Issue Date

03/07/2007

Effective Date

07/01/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

11/14/2011