DAVID W VASTINE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036046525

License Status

NOT RENEWED

Business

First Name

DAVID W

Last Name

VASTINE

Suffix

Business Name

DAVID W VASTINE MD

Original Issue Date

09/18/1972

Effective Date

09/18/1972

City

OAK PARK

State

Zip

60302

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006