MIROSLAW JAN WALO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****59

License Status

NOT RENEWED

Business

First Name

MIROSLAW

Middle

JAN

Last Name

WALO

Suffix

Business Name

MIROSLAW JAN WALO MD

Original Issue Date

08/29/1996

Effective Date

08/29/1996

Expiration Date

07/31/2002

City

PARK RIDGE

State

Zip

60068

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020