RICHARD BANJASTI CHUSAK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036086074

License Status

NOT RENEWED

Business

First Name

RICHARD BANJASTI

Last Name

CHUSAK

Suffix

Business Name

RICHARD BANJASTI CHUSAK MD

Original Issue Date

05/17/1993

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

RED BUD

State

Zip

62278

County

RANDOLPH

Ever Disciplined

LastModifiedDate

11/06/2008