MICHAEL DOUGLAS MICHENER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****55

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

DOUGLAS

Last Name

MICHENER

Suffix

Business Name

MICHAEL DOUGLAS MICHENER MD

Original Issue Date

09/09/2005

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

BELLEVILLE

State

Zip

62220

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011