STEVEN BLAISE TYSKA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****69

License Status

NOT RENEWED

Business

First Name

STEVEN BLAISE

Last Name

TYSKA

Suffix

Business Name

STEVEN BLAISE TYSKA MD

Original Issue Date

09/23/1996

Effective Date

09/23/1996

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60622

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006