THADDEUS J MANCZKO MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036534

License Status

CANCELLED

Business

First Name

THADDEUS

Middle

Last Name

MANCZKO

Suffix

Business Name

THADDEUS J MANCZKO MD

Original Issue Date

06/10/1997

Effective Date

06/10/1997

Expiration Date

06/30/2000

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

09/22/2006