BRYAN K MIKSANEK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****15

License Status

NOT RENEWED

Business

First Name

BRYAN K

Last Name

MIKSANEK

Suffix

Business Name

BRYAN K MIKSANEK MD

Original Issue Date

06/16/1995

Effective Date

06/16/1995

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60616

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020