License holder summary

Mark Vincent Konicki is a Temporary Medical Doctor Permit licensed to practice in Indiana. The address on file for Mark Vincent Konicki is Fort Wayne IN 46804. This licensed professional license is not current. The license was granted 10/04/2012 and expired on 01/04/2013.

Indiana

Professional Licensing Agency

Mark Vincent Konicki
Temporary Medical Doctor Permit
License number
99054172A
Date granted
10/04/2012
Date expires
01/04/2013
Class
Temporary Medical Doctor Permit
Status
Superceded
Address
Fort Wayne IN 46804
indianalicensing.org
ID 27838580
LAST UPDATED 2024-04-27 22:06:33 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

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