ANIKA LYSE MIRICK MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125063891

License Status

EXPIRED

Business

First Name

ANIKA

Middle

LYSE

Last Name

MIRICK

Suffix

Business Name

ANIKA LYSE MIRICK MD

Original Issue Date

06/19/2013

Effective Date

06/19/2013

Expiration Date

06/18/2014

City

BERWYN

State

Zip

60402

County

COOK

Specialty/Qualifier

Transitional Year

Ever Disciplined

LastModifiedDate

03/13/2015