DMITRIY S TCKACHENKO MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045354

License Status

CANCELLED

Business

First Name

DMITRIY

Middle

Last Name

TCKACHENKO

Suffix

Business Name

DMITRIY S TCKACHENKO MD

Original Issue Date

07/15/2002

Effective Date

07/15/2002

Expiration Date

07/14/2005

City

EVANSTON

State

Zip

60202

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006