KLAUS J STAISCH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

CANCELLED

Business

First Name

KLAUS J

Last Name

STAISCH

Suffix

Business Name

KLAUS J STAISCH MD

Original Issue Date

08/25/1997

Effective Date

08/25/1997

Expiration Date

07/31/2005

City

MARYVILLE

State

Zip

62062

County

MADISON

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

10/09/2006