JOSEPH ANTHONY KMIECIK MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125037263

License Status

EXPIRED

Business

First Name

JOSEPH

Middle

ANTHONY

Last Name

KMIECIK

Suffix

Business Name

JOSEPH ANTHONY KMIECIK MD

Original Issue Date

01/20/1998

Effective Date

01/20/1998

Expiration Date

01/19/1999

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006