MATTHEW ALLEN MAZUR DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050208

License Status

CANCELLED

Business

First Name

MATTHEW

Middle

ALLEN

Last Name

MAZUR

Suffix

Business Name

MATTHEW ALLEN MAZUR DO

Original Issue Date

06/22/2005

Effective Date

06/22/2005

Expiration Date

06/21/2008

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006