KENNETH E BODEK MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125019605

License Status

EXPIRED

Business

First Name

KENNETH E

Last Name

BODEK

Suffix

Business Name

KENNETH E BODEK MD

Original Issue Date

06/19/1986

Effective Date

06/19/1986

Expiration Date

06/25/1989

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006