MICHELLE LEE KIRK Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

ACTIVE

Business

First Name

MICHELLE

Middle

LEE

Last Name

KIRK

Business Name

MICHELLE LEE KIRK

Original Issue Date

10/02/2025

Effective Date

10/02/2025

Expiration Date

07/31/2026

City

HAWTHORNE

State

Zip

10532

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/02/2025