EVAN KELTON DACKOWSKI MD - Medical Doctor License in Illinois | # 125078712

EVAN KELTON DACKOWSKI MD

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125078712

License Status

CANCELLED

Business

N

Title

MD

First Name

EVAN

Middle

KELTON

Last Name

DACKOWSKI

Business Name

EVAN KELTON DACKOWSKI MD

Original Issue Date

07/01/2022

Effective Date

07/01/2022

Expiration Date

06/30/2024

State

IL

Specialty/Qualifier

Ophthalmology

Ever Disciplined

N

LastModifiedDate

04/06/2022