JAN K WIACEK Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125028542

License Status

EXPIRED

Business

First Name

JAN K

Last Name

WIACEK

Business Name

JAN K WIACEK

Original Issue Date

06/02/1992

Effective Date

06/02/1992

Expiration Date

06/30/1995

City

CHICAGO

State

Zip

60631

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006