MARK STANLEY PUCZYNSKI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036054582

License Status

NOT RENEWED

Business

First Name

MARK STANLEY

Last Name

PUCZYNSKI

Suffix

Business Name

MARK STANLEY PUCZYNSKI MD

Original Issue Date

05/13/1977

Effective Date

06/18/2014

Expiration Date

07/31/2017

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Ever Disciplined

LastModifiedDate

11/01/2017