AMANDA VASTAG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036139917

License Status

NOT RENEWED

Business

Title

First Name

AMANDA

Last Name

VASTAG

Business Name

AMANDA VASTAG MD

Original Issue Date

03/02/2016

Effective Date

06/12/2017

Expiration Date

09/30/2020

City

PEORIA

State

Zip

61602

County

PEORIA

Ever Disciplined

LastModifiedDate

01/14/2021