BRIAN MIKULAN MAXFIELD DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125064783

License Status

CANCELLED

Business

Title

First Name

BRIAN

Middle

MIKULAN

Last Name

MAXFIELD

Business Name

BRIAN MIKULAN MAXFIELD DO

Original Issue Date

07/01/2014

Effective Date

07/01/2014

Expiration Date

06/30/2017

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

05/29/2014