RANDALL J KRYSTOSEK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036046015

License Status

NOT RENEWED

Business

First Name

RANDALL J

Last Name

KRYSTOSEK

Suffix

Business Name

RANDALL J KRYSTOSEK MD

Original Issue Date

08/17/1972

Effective Date

08/17/1972

Expiration Date

07/01/1982

City

LOMBARD

State

Zip

60148

County

KENTUCKY

Ever Disciplined

LastModifiedDate

09/20/2006