MIROSLAW JAN WALO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

NOT RENEWED

Business

First Name

MIROSLAW

Middle

JAN

Last Name

WALO

Suffix

Business Name

MIROSLAW JAN WALO MD

Original Issue Date

08/06/1996

Effective Date

08/06/1996

Expiration Date

07/31/2002

City

DEERFIELD

State

Zip

60015

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020