C DANIEL PAVELKA DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125044780

License Status

EXPIRED

Business

First Name

Middle

DANIEL

Last Name

PAVELKA

Suffix

Business Name

C DANIEL PAVELKA DO

Original Issue Date

06/19/2002

Effective Date

06/19/2002

Expiration Date

06/30/2007

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

07/03/2007