ZACHARY DAVID MICHALICEK DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125061507

License Status

CANCELLED

Business

Title

First Name

ZACHARY

Middle

DAVID

Last Name

MICHALICEK

Business Name

ZACHARY DAVID MICHALICEK DO

Original Issue Date

06/24/2012

Effective Date

06/24/2012

Expiration Date

06/23/2015

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Pathology

Ever Disciplined

LastModifiedDate

03/24/2014