MICHAEL P VERCIMAK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

NOT RENEWED

Business

First Name

MICHAEL P

Last Name

VERCIMAK

Suffix

Business Name

MICHAEL P VERCIMAK MD

Original Issue Date

10/27/1983

Effective Date

09/07/2017

Expiration Date

09/30/2020

City

MENDOTA

State

Zip

61342

County

LA SALLE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021