BRIAN EDMUND WALCZAK DO Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070013694

License Status

NOT RENEWED

Business

Title

First Name

BRIAN

Middle

EDMUND

Last Name

WALCZAK

Business Name

BRIAN EDMUND WALCZAK DO

Original Issue Date

11/04/2003

Effective Date

10/01/2006

Expiration Date

09/30/2008

City

NAPERVILLE

State

Zip

60563

County

DUPAGE

Ever Disciplined

LastModifiedDate

11/06/2008