CASEY ROY VICKSTROM MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING RESIDENT

License Number

188000994

License Status

EXPIRED

Business

Title

First Name

CASEY

Middle

ROY

Last Name

VICKSTROM

Business Name

CASEY ROY VICKSTROM MD

Original Issue Date

03/20/2023

Effective Date

03/20/2023

Expiration Date

09/19/2023

City

SWANSEA

State

Zip

62226

County

SAINT CLAIR

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

03/06/2024