JAN K WIACEK Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****13

License Status

NOT RENEWED

Business

First Name

JAN K

Last Name

WIACEK

Business Name

JAN K WIACEK

Original Issue Date

07/13/1994

Effective Date

07/20/2020

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60634

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023