THEODORE ANTHONY KOSTIUK IV DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055973

License Status

EXPIRED

Business

First Name

THEODORE

Middle

ANTHONY

Last Name

KOSTIUK IV

Suffix

Business Name

THEODORE ANTHONY KOSTIUK IV DO

Original Issue Date

07/01/2012

Effective Date

07/01/2012

Expiration Date

06/30/2014

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Specialty/Qualifier

Orthopaedic Surgery

Ever Disciplined

LastModifiedDate

03/13/2015