RYAN BERNARD MITACEK MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130001362

License Status

EXPIRED

Business

Title

First Name

RYAN

Middle

BERNARD

Last Name

MITACEK

Business Name

RYAN BERNARD MITACEK MD

Original Issue Date

05/01/2020

Effective Date

05/01/2020

Expiration Date

05/31/2020

City

CHICAGO

State

Zip

60607

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

11/19/2020