TADEUSZ DZIADEK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****71

License Status

NOT RENEWED

Business

First Name

TADEUSZ

Last Name

DZIADEK

Suffix

Business Name

TADEUSZ DZIADEK MD

Original Issue Date

12/05/2000

Effective Date

12/05/2000

Expiration Date

07/31/2005

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011