CHARLES EDWIN MICHAELIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****61

License Status

NOT RENEWED

Business

First Name

CHARLES EDWIN

Last Name

MICHAELIS

Suffix

Business Name

CHARLES EDWIN MICHAELIS MD

Original Issue Date

01/28/1985

Effective Date

01/28/1985

Expiration Date

07/31/1987

City

MATTOON

State

Zip

61938

County

COLES

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006