GEOFFREY EDWARD MICKELLS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036130375

License Status

NOT RENEWED

Business

Title

First Name

GEOFFREY

Middle

EDWARD

Last Name

MICKELLS

Business Name

GEOFFREY EDWARD MICKELLS MD

Original Issue Date

05/14/2012

Effective Date

07/21/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60613

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017