EUGENE P KOSYAK Athletics Professional License verification

Business Entity

NOT RENEWED

License Type

Athletics Professional

Description

ATHLETICS - LICENSED PHYSICIAN

License Number

002020155-0002

License Status

NOT RENEWED

Business

First Name

EUGENE P

Last Name

KOSYAK

Business Name

EUGENE P KOSYAK

Original Issue Date

07/02/1975

Effective Date

07/02/1975

Expiration Date

07/02/1976

City

HOOPESTON

State

Zip

60942

County

WABASH

Ever Disciplined

LastModifiedDate

09/18/2006