TOMASZ PIOTR LIS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058620

License Status

CANCELLED

Business

Title

First Name

TOMASZ

Middle

PIOTR

Last Name

LIS

Business Name

TOMASZ PIOTR LIS MD

Original Issue Date

07/01/2010

Effective Date

07/01/2010

Expiration Date

06/30/2013

City

PLAINFIELD

State

Zip

60585

County

WILL

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

04/21/2010