RYAN K PHASOUK MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047031

License Status

EXPIRED

Business

First Name

RYAN

Middle

Last Name

PHASOUK

Suffix

Business Name

RYAN K PHASOUK MD

Original Issue Date

07/15/2003

Effective Date

07/15/2003

Expiration Date

07/14/2006

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006