AUTUMN EVA BERNICKY DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125076432

License Status

CANCELLED

Business

Title

First Name

AUTUMN

Middle

EVA

Last Name

BERNICKY

Business Name

AUTUMN EVA BERNICKY DO

Original Issue Date

06/23/2020

Effective Date

06/23/2020

Expiration Date

06/22/2023

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/06/2020