BIANKA SARA KSIAZEK DPM Podiatrist License verification

Business Entity

ACTIVE

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135001244

License Status

ACTIVE

Business

Title

DPM

First Name

BIANKA

Middle

SARA

Last Name

KSIAZEK

Business Name

BIANKA SARA KSIAZEK DPM

Original Issue Date

07/10/2024

Effective Date

07/10/2024

Expiration Date

07/09/2027

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

07/10/2024