NICHOLAS EDWARD MAZUR DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059731

License Status

CANCELLED

Business

Title

First Name

NICHOLAS

Middle

EDWARD

Last Name

MAZUR

Business Name

NICHOLAS EDWARD MAZUR DO

Original Issue Date

07/01/2011

Effective Date

07/01/2011

Expiration Date

06/30/2014

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

06/06/2011