EDWIN MANDIEKA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071884

License Status

EXPIRED

Business

First Name

EDWIN

Last Name

MANDIEKA

Business Name

EDWIN MANDIEKA

Original Issue Date

06/20/2018

Effective Date

06/20/2018

Expiration Date

06/19/2021

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

04/25/2025