MATTHEW J LICKERMAN 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

MATTHEW

Middle

Last Name

LICKERMAN

Business Name

MATTHEW J LICKERMAN

Original Issue Date

09/06/2002

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

BUFFALO GROVE

State

Zip

60089

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011