GAIL J MICK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****80

License Status

NOT RENEWED

Business

First Name

GAIL

Middle

Last Name

MICK

Suffix

Business Name

GAIL J MICK MD

Original Issue Date

11/23/1998

Effective Date

11/23/1998

Expiration Date

07/31/2002

City

PEORIA

State

Zip

61637

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006