BRIAN MICHAEL KOSTUK DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125051589

License Status

CANCELLED

Business

First Name

BRIAN

Middle

MICHAEL

Last Name

KOSTUK

Suffix

Business Name

BRIAN MICHAEL KOSTUK DO

Original Issue Date

07/01/2007

Effective Date

07/01/2007

Expiration Date

06/30/2009

City

SOUTH ELGIN

State

Zip

60177

County

KANE

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

05/07/2007