MIKELSON MOMPREMIER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

ACTIVE

Business

Title

First Name

MIKELSON

Last Name

MOMPREMIER

Business Name

MIKELSON MOMPREMIER MD

Original Issue Date

08/27/2023

Effective Date

08/27/2023

Expiration Date

07/31/2026

City

DESOTO

State

Zip

75115

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/24/2026