EVAN KELTON DACKOWSKI MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125078712

License Status

CANCELLED

Business

Title

First Name

EVAN

Middle

KELTON

Last Name

DACKOWSKI

Business Name

EVAN KELTON DACKOWSKI MD

Original Issue Date

07/01/2022

Effective Date

07/01/2022

Expiration Date

06/30/2024

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Ophthalmology

Ever Disciplined

LastModifiedDate

04/06/2022