AUSTEN LUKE STASIAK MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057200

License Status

EXPIRED

Business

Title

First Name

AUSTEN

Middle

LUKE

Last Name

STASIAK

Business Name

AUSTEN LUKE STASIAK MD

Original Issue Date

07/01/2009

Effective Date

07/01/2009

Expiration Date

06/30/2012

City

QUINCY

State

Zip

62301

County

ADAMS

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

08/29/2012