NICHOLAS DANIEL KONICEK DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125084351

License Status

ACTIVE

Business

Title

First Name

NICHOLAS

Middle

DANIEL

Last Name

KONICEK

Business Name

NICHOLAS DANIEL KONICEK DO

Original Issue Date

07/01/2024

Effective Date

07/01/2024

Expiration Date

06/30/2027

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

06/07/2024