JOSE S SUBAUSTE Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036081503

License Status

NOT RENEWED

Business

First Name

JOSE S

Last Name

SUBAUSTE

Business Name

JOSE S SUBAUSTE

Original Issue Date

09/15/1990

Effective Date

09/15/1990

Expiration Date

07/31/1993

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/20/2006