MICHAEL GEORGE ANDERSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

GEORGE

Last Name

ANDERSON

Suffix

Business Name

MICHAEL GEORGE ANDERSON MD

Original Issue Date

06/28/2000

Effective Date

06/28/2000

Expiration Date

07/31/2005

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006