PETER S KONCHAK DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****55

License Status

ACTIVE

Business

First Name

PETER S

Last Name

KONCHAK

Suffix

Business Name

PETER S KONCHAK DO

Original Issue Date

08/17/1983

Effective Date

11/15/2024

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61104

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/15/2024