JOSE S SUBAUSTE Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****60

License Status

NOT RENEWED

Business

First Name

JOSE S

Last Name

SUBAUSTE

Business Name

JOSE S SUBAUSTE

Original Issue Date

11/21/1990

Effective Date

11/21/1990

Expiration Date

07/31/1993

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006