CARL JOSEPH GUSTAS SR DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****22

License Status

NOT RENEWED

Business

First Name

CARL

Middle

JOSEPH

Last Name

GUSTAS

Suffix

SR DO

Business Name

CARL JOSEPH GUSTAS SR DO

Original Issue Date

11/20/2006

Effective Date

11/20/2006

Expiration Date

07/31/2008

State

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020