GREGORY NICHOLAS KOZLOV DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125051822

License Status

CANCELLED

Business

First Name

GREGORY

Middle

NICHOLAS

Last Name

KOZLOV

Suffix

Business Name

GREGORY NICHOLAS KOZLOV DO

Original Issue Date

07/01/2008

Effective Date

07/01/2008

Expiration Date

06/30/2011

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

06/02/2008