FREDERICK R ZIVNUSKA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036073773

License Status

NOT RENEWED

Business

First Name

FREDERICK R

Last Name

ZIVNUSKA

Suffix

Business Name

FREDERICK R ZIVNUSKA MD

Original Issue Date

09/17/1986

Effective Date

09/17/1986

Expiration Date

07/31/2005

City

ALTON

State

Zip

62002

County

MADISON

Ever Disciplined

LastModifiedDate

10/09/2006