MIROSLAW JAN WALO MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125032125

License Status

EXPIRED

Business

First Name

MIROSLAW

Middle

JAN

Last Name

WALO

Suffix

Business Name

MIROSLAW JAN WALO MD

Original Issue Date

07/05/1994

Effective Date

07/05/1994

Expiration Date

07/04/1997

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006