TIMOTHY B NIEWOLD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036118757

License Status

NOT RENEWED

Business

First Name

TIMOTHY

Middle

Last Name

NIEWOLD

Suffix

Business Name

TIMOTHY B NIEWOLD MD

Original Issue Date

06/19/2007

Effective Date

07/26/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

11/17/2014