DOROTHY LAZELLE MICHAELIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****88

License Status

NOT RENEWED

Business

First Name

DOROTHY LAZELLE

Last Name

MICHAELIS

Suffix

Business Name

DOROTHY LAZELLE MICHAELIS MD

Original Issue Date

03/20/1985

Effective Date

03/20/1985

Expiration Date

07/31/1990

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006