JACEK ZDZISLAW OBARA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050438

License Status

EXPIRED

Business

First Name

JACEK

Middle

ZDZISLAW

Last Name

OBARA

Suffix

Business Name

JACEK ZDZISLAW OBARA MD

Original Issue Date

07/06/2005

Effective Date

07/06/2005

Expiration Date

07/05/2008

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

07/31/2008