JACEK WOJCIECH GRACZYKOWSKI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****87

License Status

NOT RENEWED

Business

First Name

JACEK

Middle

WOJCIECH

Last Name

GRACZYKOWSKI

Suffix

Business Name

JACEK WOJCIECH GRACZYKOWSKI MD

Original Issue Date

09/23/1996

Effective Date

06/12/2017

Expiration Date

09/30/2020

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021