THOMAS WILLIAM MICHAELIS MD Medical Doctor License verification

THOMAS WILLIAM MICHAELIS MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036109934

License Status

NOT RENEWED

Business

First Name

THOMAS

Middle

WILLIAM

Last Name

MICHAELIS

Suffix

Business Name

THOMAS WILLIAM MICHAELIS MD

Original Issue Date

08/15/2003

Effective Date

06/25/2014

Expiration Date

07/31/2017

City

SYLVANIA

State

Zip

43560

County

OHIO

Ever Disciplined

LastModifiedDate

11/01/2017

Case Number

2014007339

Action

Temporary Suspension

Discipline Start Date

08/11/2014

Discipline Reason

for unprofessional conduct and fraud or misrepresentation in applying for his Illinois physician and surgeon license, to wit: Respondent failed to disclose that he permanently surrendered his Ohio Certificate to Practice Medicine and Surgery as required by law.