PAUL TIMOTHY GUSTAFSON DO

Business Entity
ACTIVE

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****39

ACTIVE

N

PAUL

TIMOTHY

GUSTAFSON

DO

PAUL TIMOTHY GUSTAFSON DO

09/14/2010

07/13/2023

07/31/2026

SHREVEPORT

LA

71104

PRACTITIONER

II III IV V

N

07/13/2023