DOUGLAS PAUL DWORAK MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059393

License Status

CANCELLED

Business

Title

First Name

DOUGLAS

Middle

PAUL

Last Name

DWORAK

Business Name

DOUGLAS PAUL DWORAK MD

Original Issue Date

07/01/2012

Effective Date

07/01/2012

Expiration Date

06/30/2014

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Ophthalmology

Ever Disciplined

LastModifiedDate

03/24/2014