BROCK E POLNASZEK MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING RESIDENT

License Number

188000893

License Status

EXPIRED

Business

Title

First Name

BROCK

Middle

Last Name

POLNASZEK

Business Name

BROCK E POLNASZEK MD

Original Issue Date

06/15/2020

Effective Date

06/15/2020

Expiration Date

12/14/2020

City

GRANITE CITY

State

Zip

62040

County

MADISON

Specialty/Qualifier

Obstetrics and Gynecology

Ever Disciplined

LastModifiedDate

03/11/2021