THADDEUS LEWIS KOSTRUBALA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036036394

License Status

NOT RENEWED

Business

First Name

THADDEUS LEWIS

Last Name

KOSTRUBALA

Suffix

Business Name

THADDEUS LEWIS KOSTRUBALA MD

Original Issue Date

03/02/1960

Effective Date

03/02/1960

City

SAN DIEGO

State

Zip

29103

County

CALIFORNIA

Ever Disciplined

LastModifiedDate

09/20/2006