KEVIN L POLGLAZE DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036135862

License Status

NOT RENEWED

Business

Title

First Name

KEVIN

Middle

Last Name

POLGLAZE

Business Name

KEVIN L POLGLAZE DO

Original Issue Date

07/09/2014

Effective Date

04/19/2017

Expiration Date

09/30/2020

City

SKOKIE

State

Zip

60077

County

WISCONSIN

Ever Disciplined

LastModifiedDate

01/14/2021