MICHAEL D ANDERSEN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****83

License Status

NOT RENEWED

Business

First Name

MICHAEL D

Last Name

ANDERSEN

Business Name

MICHAEL D ANDERSEN

Original Issue Date

01/30/1996

Effective Date

01/30/1996

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006