EDWARD STANLEY KAPUSTKA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036041088

License Status

NOT RENEWED

Business

First Name

EDWARD STANLEY

Last Name

KAPUSTKA

Suffix

Business Name

EDWARD STANLEY KAPUSTKA MD

Original Issue Date

07/01/1967

Effective Date

07/01/1967

City

WHITE WATER

State

Zip

53190

County

WISCONSIN

Ever Disciplined

LastModifiedDate

09/20/2006