BRIAN KEITH PATRICK VICKARYOUS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000583

License Status

EXPIRED

Business

First Name

BRIAN KEITH

Middle

PATRICK

Last Name

VICKARYOUS

Suffix

Business Name

BRIAN KEITH PATRICK VICKARYOUS MD

Original Issue Date

04/07/2003

Effective Date

04/07/2003

Expiration Date

07/06/2003

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Orthopaedic Surgery

Ever Disciplined

LastModifiedDate

09/25/2006