P ERIC KONICKI MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125015353

License Status

EXPIRED

Business

First Name

P ERIC

Last Name

KONICKI

Suffix

Business Name

P ERIC KONICKI MD

Original Issue Date

06/15/1983

Effective Date

06/15/1983

Expiration Date

06/25/1985

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006