Ohio
Board of Licensing
Koniarczyk, Michael- CCF Mentor
Medical Board - 41.Pa Supervision Agreement
License number
41.16721-SA
Date granted
05/30/2013
Date expires
01/31/2015
Class
Medical Board - 41.Pa Supervision Agreement
Status
Active (In Renewal)
Address
7060 Wayside Dr., Mentor, OH 44060
ohiolicensing.org
ID 29547495
LAST UPDATED 2026-04-12 20:46:35 UTC
LAST UPDATED 2026-04-12 20:46:35 UTC