BRETT IAN SCHUPACK DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036163454

License Status

ACTIVE

Business

Title

First Name

BRETT

Middle

IAN

Last Name

SCHUPACK

Business Name

BRETT IAN SCHUPACK DO

Original Issue Date

01/19/2023

Effective Date

07/09/2023

Expiration Date

07/31/2026

City

BRIDGETON

State

Zip

63044

Ever Disciplined

LastModifiedDate

07/09/2023