MIKEL CODY TIHISTA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130001520

License Status

EXPIRED

Business

Title

First Name

MIKEL

Middle

CODY

Last Name

TIHISTA

Business Name

MIKEL CODY TIHISTA MD

Original Issue Date

11/20/2023

Effective Date

11/20/2023

Expiration Date

02/19/2024

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Orthopaedic Surgery

Ever Disciplined

LastModifiedDate

01/08/2025