MIROSLAW JAN WALO MD Medical Doctor License verification

MIROSLAW JAN WALO MD

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****20

License Status

ACTIVE

Business

First Name

MIROSLAW

Middle

JAN

Last Name

WALO

Suffix

Business Name

MIROSLAW JAN WALO MD

Original Issue Date

09/22/1999

Effective Date

06/26/2023

Expiration Date

07/31/2026

City

SKOKIE

State

Zip

60077

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/26/2023

Case Number

2001002697

Action

Probation

Discipline Start Date

03/09/2005

Discipline End Date

03/08/2006

Discipline Reason

Authorized his secretary to fill in prescription information for patients on pre-signed prescription forms.