YURY POTYLCHANSKY Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125028743

License Status

EXPIRED

Business

First Name

YURY

Last Name

POTYLCHANSKY

Business Name

YURY POTYLCHANSKY

Original Issue Date

06/15/1992

Effective Date

06/15/1992

Expiration Date

06/24/1995

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006