SEAN S KOSTOLANSKY DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125066840

License Status

CANCELLED

Business

Title

First Name

SEAN

Middle

Last Name

KOSTOLANSKY

Business Name

SEAN S KOSTOLANSKY DO

Original Issue Date

06/26/2015

Effective Date

06/26/2015

Expiration Date

06/25/2018

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

05/27/2015