MICHAL JERZY WAC 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

Title

First Name

MICHAL

Middle

JERZY

Last Name

WAC

Business Name

MICHAL JERZY WAC MD

Original Issue Date

08/06/2008

Effective Date

08/06/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011