VESNA MICIC 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

Title

First Name

VESNA

Last Name

MICIC

Business Name

VESNA MICIC MD

Original Issue Date

08/18/2014

Effective Date

08/18/2014

Expiration Date

07/31/2017

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017