IRENA VIVIAN VITKOVITSKY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036130034

License Status

NOT RENEWED

Business

Title

First Name

IRENA

Middle

VIVIAN

Last Name

VITKOVITSKY

Business Name

IRENA VIVIAN VITKOVITSKY MD

Original Issue Date

04/11/2012

Effective Date

07/27/2017

Expiration Date

09/30/2020

City

SAINT LOUIS

State

Zip

63104

County

MISSOURI

Ever Disciplined

LastModifiedDate

01/14/2021