DUANE VANCE MYKLEJORD DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125075217

License Status

CANCELLED

Business

Title

First Name

DUANE

Middle

VANCE

Last Name

MYKLEJORD

Business Name

DUANE VANCE MYKLEJORD DO

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2022

City

MAYWOOD

State

Zip

60153

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

05/07/2019