P JOHN KONICKI Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

NOT RENEWED

Business

First Name

P JOHN

Last Name

KONICKI

Business Name

P JOHN KONICKI

Original Issue Date

08/07/1995

Effective Date

08/07/1995

Expiration Date

07/31/2005

City

ARLINGTON HEIGHTS

State

Zip

60005

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020