EDMUND W VIZINAS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****28

License Status

NOT RENEWED

Business

First Name

EDMUND W

Last Name

VIZINAS

Business Name

EDMUND W VIZINAS

Original Issue Date

01/01/1997

Effective Date

05/03/2017

Expiration Date

09/30/2020

City

WILLOWBROOK

State

Zip

60527

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021