Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****81

NOT RENEWED

N

MD

KRYSTAL

M

BACIAK

KRYSTAL M BACIAK MD

04/24/2017

09/16/2020

07/31/2023

EDOMNDS

WA

98026

COOK

PRACTITIONER

II III IV V

N

11/30/2023