FRANK CHARLES MICEK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****89

License Status

NOT RENEWED

Business

First Name

FRANK

Middle

CHARLES

Last Name

MICEK

Suffix

Business Name

FRANK CHARLES MICEK MD

Original Issue Date

01/01/1997

Effective Date

06/26/2017

Expiration Date

09/30/2020

City

NORMAL

State

Zip

61761

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021