MATTHEW JUSTIN NIEDZWIECKI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****25

License Status

ACTIVE

Business

Title

First Name

MATTHEW

Middle

JUSTIN

Last Name

NIEDZWIECKI

Business Name

MATTHEW JUSTIN NIEDZWIECKI MD

Original Issue Date

06/21/2012

Effective Date

05/17/2023

Expiration Date

07/31/2026

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/17/2023