DANIEL JOSEPH MIZWICKI Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****11

License Status

NOT RENEWED

Business

First Name

DANIEL

Middle

JOSEPH

Last Name

MIZWICKI

Business Name

DANIEL JOSEPH MIZWICKI

Original Issue Date

10/07/2013

Effective Date

01/07/2020

Expiration Date

03/01/2022

City

SKOKIE

State

Zip

60076

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022