Mark Vincent Konicki

Temporary Medical Doctor Permit

Indiana  99054172A   Superceded

This Indiana license was held by Mark Vincent Konicki. The license is no longer active. It was granted on 10/04/2012 and expired on 01/04/2013

LICENSE DETAILS

  • License Number: 99054172A
  • Category: Temporary MD Permit
  • Status: Superceded
  • Date Granted: 10/04/2012 (over 12 years ago)
  • Expiry Date: 01/04/2013 (over 12 years ago)

LOCATIONS

A Address

Fort Wayne IN 46804