CARLOS S SUBAUSTE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

NOT RENEWED

Business

First Name

CARLOS S

Last Name

SUBAUSTE

Suffix

Business Name

CARLOS S SUBAUSTE MD

Original Issue Date

11/05/1985

Effective Date

11/05/1985

Expiration Date

07/31/1990

City

SPRINGFIELD

State

Zip

62781

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006