FRED B KYAZZE Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125027019

License Status

EXPIRED

Business

First Name

FRED

Middle

Last Name

KYAZZE

Business Name

FRED B KYAZZE

Original Issue Date

05/30/1991

Effective Date

05/30/1991

Expiration Date

06/30/1994

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006