WALDEMAR MYSIAK - Medical Doctor License in Idaho | # 036099938

WALDEMAR MYSIAK

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036099938

License Status

NOT RENEWED

Business

N

First Name

WALDEMAR

Last Name

MYSIAK

Business Name

WALDEMAR MYSIAK

Original Issue Date

03/30/1999

Effective Date

08/26/2020

Expiration Date

07/31/2023

State

ID

Ever Disciplined

N

LastModifiedDate

11/30/2023