BRIAN EDMUND WALCZAK DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000826

License Status

EXPIRED

Business

Title

First Name

BRIAN

Middle

EDMUND

Last Name

WALCZAK

Business Name

BRIAN EDMUND WALCZAK DO

Original Issue Date

07/01/2010

Effective Date

07/01/2010

Expiration Date

07/31/2010

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Orthopaedic Surgery

Ever Disciplined

LastModifiedDate

10/13/2010