P ERIC KONICKI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036070060

License Status

NOT RENEWED

Business

First Name

P ERIC

Last Name

KONICKI

Suffix

Business Name

P ERIC KONICKI MD

Original Issue Date

01/30/1985

Effective Date

01/30/1985

Expiration Date

07/31/1987

City

CHICAGO

State

Zip

60615

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006