J MICHAEL PANUSKA MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****14

License Status

INACTIVE

Business

First Name

J MICHAEL

Last Name

PANUSKA

Suffix

Business Name

J MICHAEL PANUSKA MD

Original Issue Date

12/23/1985

Effective Date

04/24/2017

Expiration Date

09/30/2020

City

BRADLEY

State

Zip

60915

County

KANKAKEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/24/2017