Credential Summary - Renewal Requirements

Credential Summary for 21403-20
Name: Micke, Bernard F
Credential Type: MEDICINE AND SURGERY (20)
Credential Number: 21403-20
Location: MADISON, WI
License Type: regular
Status License is current (Active)
Eligible To Practice: credential license is current
First Fee Received: YES

DetailsRequirementsPaymentsOrdersRelationships
Renewal requirements for the year: 2021
Requirement Code Complied? Complied Date
FEE requirement complied 10/07/2021
SIG requirement complied 10/07/2021


Requirement Code Description

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