MARIOLA JACKOWSKI MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048648

License Status

CANCELLED

Business

First Name

MARIOLA

Last Name

JACKOWSKI

Suffix

Business Name

MARIOLA JACKOWSKI MD

Original Issue Date

07/01/2004

Effective Date

07/01/2004

Expiration Date

06/30/2007

City

ARLINGTON HEIGHTS

State

Zip

60005

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006