MICHELLE DIANE LUNDHOLM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****17

License Status

ACTIVE

Business

Title

First Name

MICHELLE

Middle

DIANE

Last Name

LUNDHOLM

Business Name

MICHELLE DIANE LUNDHOLM MD

Original Issue Date

05/07/2020

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023