MICHAEL J FORSETH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****45

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

Last Name

FORSETH

Suffix

Business Name

MICHAEL J FORSETH MD

Original Issue Date

01/28/1998

Effective Date

01/28/1998

Expiration Date

07/31/2002

City

MAYWOOD

State

Zip

60153

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006