MICHAEL J IWANICKI DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036033

License Status

EXPIRED

Business

First Name

MICHAEL

Middle

Last Name

IWANICKI

Suffix

Business Name

MICHAEL J IWANICKI DO

Original Issue Date

05/14/1997

Effective Date

05/14/1997

Expiration Date

06/30/2002

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/22/2006