DIJANA POLJAK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****08

License Status

NOT RENEWED

Business

Title

First Name

DIJANA

Last Name

POLJAK

Business Name

DIJANA POLJAK MD

Original Issue Date

02/22/2019

Effective Date

02/22/2019

Expiration Date

09/30/2020

City

PORT JEFFERSON STATION

State

Zip

11776

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021