SCOTT CASIMER GOGULSKI DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

CANCELLED

Business

First Name

SCOTT

Middle

CASIMER

Last Name

GOGULSKI

Suffix

Business Name

SCOTT CASIMER GOGULSKI DO

Original Issue Date

04/10/2003

Effective Date

04/10/2003

Expiration Date

07/31/2008

City

CARTHAGE

State

Zip

62321

County

HANCOCK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2008