ADAM G LYSIAK MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125075007

License Status

CANCELLED

Business

Title

First Name

ADAM

Middle

Last Name

LYSIAK

Business Name

ADAM G LYSIAK MD

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2022

City

MAYWOOD

State

Zip

60153

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

06/14/2019