MARY L KLODNYCKY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****83

License Status

NOT RENEWED

Business

First Name

MARY L

Last Name

KLODNYCKY

Suffix

Business Name

MARY L KLODNYCKY MD

Original Issue Date

07/30/1996

Effective Date

07/24/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60622

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021