AGNIESZKA MARIA MANIAK MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125072603

License Status

CANCELLED

Business

Title

First Name

AGNIESZKA

Middle

MARIA

Last Name

MANIAK

Business Name

AGNIESZKA MARIA MANIAK MD

Original Issue Date

07/01/2018

Effective Date

07/01/2018

Expiration Date

06/30/2021

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/10/2018