KRYSTAL M BACIAK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036143060

License Status

NOT RENEWED

Business

Title

First Name

KRYSTAL

Middle

Last Name

BACIAK

Business Name

KRYSTAL M BACIAK MD

Original Issue Date

04/24/2017

Effective Date

09/16/2020

Expiration Date

07/31/2023

City

EDMONDS

State

Zip

98026

Ever Disciplined

LastModifiedDate

11/30/2023