MATTHEW MIECZYSLAW ZAK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

NOT RENEWED

Business

First Name

MATTHEW

Middle

MIECZYSLAW

Last Name

ZAK

Suffix

Business Name

MATTHEW MIECZYSLAW ZAK MD

Original Issue Date

02/01/2005

Effective Date

02/01/2005

Expiration Date

07/31/2008

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011