MIRIAM ALTAGRACIA DICKSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****62

License Status

ACTIVE

Business

Title

First Name

MIRIAM

Middle

ALTAGRACIA

Last Name

DICKSON

Business Name

MIRIAM ALTAGRACIA DICKSON MD

Original Issue Date

07/29/2016

Effective Date

04/18/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/18/2023