BETH A MIKKELSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****48

License Status

NOT RENEWED

Business

First Name

BETH A

Last Name

MIKKELSEN

Suffix

Business Name

BETH A MIKKELSEN MD

Original Issue Date

09/06/1984

Effective Date

09/06/1984

Expiration Date

07/31/1987

City

OAK PARK

State

Zip

60302

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006