MARK PORVAZNIK DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING RESIDENT

License Number

188000888

License Status

EXPIRED

Business

Title

First Name

MARK

Last Name

PORVAZNIK

Business Name

MARK PORVAZNIK DO

Original Issue Date

09/03/2021

Effective Date

09/03/2021

Expiration Date

03/02/2022

City

FREEPORT

State

Zip

61032

County

STEPHENSON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

10/11/2022