HENRIK MIKE-MAYER MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****75

NOT RENEWED

N

HENRIK

MIKE-MAYER

MD

HENRIK MIKE-MAYER MD

12/14/2001

12/14/2001

07/31/2002

DECATUR

IL

62526

MACON

II III IV V

N

10/09/2006