VIROON MAVICHAK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036059895

License Status

NOT RENEWED

Business

First Name

VIROON

Last Name

MAVICHAK

Suffix

Business Name

VIROON MAVICHAK MD

Original Issue Date

12/18/1979

Effective Date

12/18/1979

Expiration Date

07/01/1982

City

ALSIP

State

Zip

60658

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006