KATHLEEN MARIE DZIEDZIC Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036104587

License Status

NOT RENEWED

Business

First Name

KATHLEEN MARIE

Last Name

DZIEDZIC

Suffix

Business Name

KATHLEEN MARIE DZIEDZIC

Original Issue Date

04/25/2001

Effective Date

04/25/2001

Expiration Date

07/31/2005

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/09/2006