AUSTIN DANIEL STREET MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036128018

License Status

NOT RENEWED

Business

First Name

AUSTIN

Middle

DANIEL

Last Name

STREET

Suffix

Business Name

AUSTIN DANIEL STREET MD

Original Issue Date

06/02/2011

Effective Date

06/02/2011

Expiration Date

07/31/2014

City

ST LOUIS

State

Zip

63104

County

MISSOURI

Ever Disciplined

LastModifiedDate

11/17/2014