MICHAEL G DOUGLAS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****97

License Status

NOT RENEWED

Business

First Name

MICHAEL G

Last Name

DOUGLAS

Business Name

MICHAEL G DOUGLAS

Original Issue Date

08/07/1996

Effective Date

08/07/1996

Expiration Date

07/31/1999

City

SPRINGFIELD

State

Zip

62781

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006