FREDERICK R ZIVNUSKA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****47

License Status

NOT RENEWED

Business

First Name

FREDERICK R

Last Name

ZIVNUSKA

Suffix

Business Name

FREDERICK R ZIVNUSKA MD

Original Issue Date

06/15/1989

Effective Date

06/15/1989

Expiration Date

07/31/2005

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006