LARA MARIE WIZIECKI DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036100432

License Status

ACTIVE

Business

First Name

LARA

Middle

MARIE

Last Name

WIZIECKI

Suffix

Business Name

LARA MARIE WIZIECKI DO

Original Issue Date

06/24/1999

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

ORLAND PARK

State

Zip

60462

County

COOK

Ever Disciplined

LastModifiedDate

04/11/2023