KURT W ERICKSON 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

KURT W

Last Name

ERICKSON

Suffix

Business Name

KURT W ERICKSON MD

Original Issue Date

06/17/2004

Effective Date

06/17/2004

Expiration Date

07/31/2008

City

MERRIONETTE PARK

State

Zip

60803

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020