JACK W ROSTAS III MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036143962

License Status

NOT RENEWED

Business

Title

First Name

JACK

Middle

Last Name

ROSTAS

Suffix

III

Business Name

JACK W ROSTAS III MD

Original Issue Date

07/27/2017

Effective Date

07/27/2017

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

01/14/2021