DANIEL JOSEPH MIZWICKI Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004786

License Status

NOT RENEWED

Business

First Name

DANIEL

Middle

JOSEPH

Last Name

MIZWICKI

Business Name

DANIEL JOSEPH MIZWICKI

Original Issue Date

07/31/2013

Effective Date

01/07/2020

Expiration Date

03/01/2022

City

NEW LENOX

State

Zip

60451

County

WILL

Ever Disciplined

LastModifiedDate

07/27/2022