TERESA M KLYSZEJKO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****55

License Status

NOT RENEWED

Business

First Name

TERESA M

Last Name

KLYSZEJKO

Business Name

TERESA M KLYSZEJKO

Original Issue Date

04/18/1986

Effective Date

04/18/1986

Expiration Date

07/31/2002

City

BELVIDERE

State

Zip

61008

County

BOONE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006