| | Physician Last Name: | Syrquin |
| | Physician First Name: | Mickey |
| | Physician Middle Name: | G |
| | Address: | Dakota Clinic Ltd.
3000 32nd Avenue South
Fargo, North Dakota 58104 |
| | License Number: | 179512 |
| | License Type: | MD |
| | Year of Birth: |
1960
|
| | Effective Date: | 05/23/2002 |
| | Action Description for DOH Webpage: | License suspension until the completion of the terms of probation imposed by the North Dakota State Board of Medical Examiners and until a modification order staying the suspension is issued by the New York State Board for Professional Medical Conduct. |
| | Misconduct Description for DOH Webpage: | The physician did not contest the charge of having been convicted in Municipal Court, City of Fargo, Cass County, North Dakota of Driving Under the Influence. |
| | License Limitations or Conditions for DOH Webpage: | |
| | Board Order: |
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