PETER THOMAS ZAVISLAK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

NOT RENEWED

Business

Title

First Name

PETER

Middle

THOMAS

Last Name

ZAVISLAK

Business Name

PETER THOMAS ZAVISLAK MD

Original Issue Date

05/05/2014

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60605

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021