KEVIN P NIEZGODA DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125026535

License Status

EXPIRED

Business

First Name

KEVIN

Middle

Last Name

NIEZGODA

Suffix

Business Name

KEVIN P NIEZGODA DO

Original Issue Date

05/09/1991

Effective Date

05/09/1991

Expiration Date

06/30/1994

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

09/22/2006