LEIF-DAVID ERIKSEN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

NOT RENEWED

Business

First Name

LEIF-DAVID

Last Name

ERIKSEN

Business Name

LEIF-DAVID ERIKSEN

Original Issue Date

10/20/1993

Effective Date

10/20/1993

Expiration Date

07/31/2002

City

BERWYN

State

Zip

60402

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006