FABIANA KOTOVICZ MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059061

License Status

EXPIRED

Business

First Name

FABIANA

Last Name

KOTOVICZ

Suffix

Business Name

FABIANA KOTOVICZ MD

Original Issue Date

07/01/2011

Effective Date

07/01/2011

Expiration Date

06/30/2014

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/13/2015