CARLOS S SUBAUSTE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125016896

License Status

EXPIRED

Business

First Name

CARLOS S

Last Name

SUBAUSTE

Suffix

Business Name

CARLOS S SUBAUSTE MD

Original Issue Date

06/22/1984

Effective Date

06/22/1984

Expiration Date

06/26/1986

City

SPRINGFIELD

State

Zip

62708

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006