KAREN A LICKENBROCK MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****40

License Status

CANCELLED

Business

First Name

KAREN A

Last Name

LICKENBROCK

Suffix

Business Name

KAREN A LICKENBROCK MD

Original Issue Date

10/25/1987

Effective Date

10/25/1987

Expiration Date

07/31/1990

City

DECATUR

State

Zip

62526

County

MACON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006