THOMAS A CISZEK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****13

License Status

NOT RENEWED

Business

First Name

THOMAS A

Last Name

CISZEK

Suffix

Business Name

THOMAS A CISZEK MD

Original Issue Date

08/19/1981

Effective Date

08/19/1981

Expiration Date

07/31/1987

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006