MARY ANN POLASCIK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****29

License Status

NOT RENEWED

Business

First Name

MARY ANN

Last Name

POLASCIK

Suffix

Business Name

MARY ANN POLASCIK MD

Original Issue Date

01/01/1997

Effective Date

07/20/2011

Expiration Date

07/31/2014

City

DIXON

State

Zip

61021

County

LEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014