MICHAEL DAVID PHILLIPS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****51

License Status

CANCELLED

Business

First Name

MICHAEL

Middle

DAVID

Last Name

PHILLIPS

Suffix

Business Name

MICHAEL DAVID PHILLIPS MD

Original Issue Date

03/16/1999

Effective Date

03/16/1999

Expiration Date

07/31/2005

City

DANVILLE

State

Zip

61834

County

VERMILION

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006