JOSE S SUBAUSTE Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125022847

License Status

EXPIRED

Business

First Name

JOSE S

Last Name

SUBAUSTE

Business Name

JOSE S SUBAUSTE

Original Issue Date

06/22/1988

Effective Date

06/22/1988

Expiration Date

06/26/1991

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006