JAMES THOMAS STASIAK MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125017447

License Status

EXPIRED

Business

First Name

JAMES THOMAS

Last Name

STASIAK

Suffix

Business Name

JAMES THOMAS STASIAK MD

Original Issue Date

07/10/1984

Effective Date

07/10/1984

Expiration Date

07/01/1986

City

PEORIA

State

Zip

61636

County

PEORIA

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/22/2006