MICHAEL ROBERT ANSANI DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036112382

License Status

ACTIVE

Business

First Name

MICHAEL

Middle

ROBERT

Last Name

ANSANI

Suffix

Business Name

MICHAEL ROBERT ANSANI DO

Original Issue Date

09/17/2004

Effective Date

07/15/2023

Expiration Date

07/31/2026

City

RACINE

State

Zip

53405

Ever Disciplined

LastModifiedDate

07/15/2023