KONSTANTIN S DZAMASHVILI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036093821

License Status

NOT RENEWED

Business

First Name

KONSTANTIN S

Last Name

DZAMASHVILI

Suffix

Business Name

KONSTANTIN S DZAMASHVILI MD

Original Issue Date

07/29/1996

Effective Date

04/11/2014

Expiration Date

07/31/2017

City

WINFIELD

State

Zip

60190

County

DUPAGE

Ever Disciplined

LastModifiedDate

11/01/2017