DAVID BRIAN JANIZEK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

NOT RENEWED

Business

Title

First Name

DAVID

Middle

BRIAN

Last Name

JANIZEK

Business Name

DAVID BRIAN JANIZEK MD

Original Issue Date

05/12/2010

Effective Date

06/27/2011

Expiration Date

07/31/2014

City

FORT WAYNE

State

Zip

46804

County

INDIANA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014