ROMAN TARASOVYCH PYASTA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****84

License Status

NOT RENEWED

Business

First Name

ROMAN

Middle

TARASOVYCH

Last Name

PYASTA

Suffix

Business Name

ROMAN TARASOVYCH PYASTA MD

Original Issue Date

06/29/2001

Effective Date

06/29/2001

Expiration Date

07/31/2005

City

METROPOLIS

State

Zip

62960

County

MASSAC

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006