MICHAEL N KIRK Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****17

License Status

NOT RENEWED

Business

First Name

MICHAEL N

Last Name

KIRK

Business Name

MICHAEL N KIRK

Original Issue Date

06/14/2018

Effective Date

06/14/2018

Expiration Date

09/30/2020

City

WATERLOO

State

Zip

62298

County

MONROE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021