MICHAL JERZY WAC MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050603

License Status

CANCELLED

Business

Title

First Name

MICHAL

Middle

JERZY

Last Name

WAC

Business Name

MICHAL JERZY WAC MD

Original Issue Date

06/21/2006

Effective Date

06/21/2006

Expiration Date

06/20/2009

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006