TIMOTHY MICHAEL VAVRA DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034884

License Status

EXPIRED

Business

First Name

TIMOTHY

Middle

MICHAEL

Last Name

VAVRA

Suffix

Business Name

TIMOTHY MICHAEL VAVRA DO

Original Issue Date

06/05/1996

Effective Date

06/05/1996

Expiration Date

06/21/1999

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006