MATTHEW MICHAEL CHURPEK MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125049710

License Status

CANCELLED

Business

First Name

MATTHEW

Middle

MICHAEL

Last Name

CHURPEK

Suffix

Business Name

MATTHEW MICHAEL CHURPEK MD

Original Issue Date

06/24/2005

Effective Date

06/24/2005

Expiration Date

06/23/2008

City

WAUNAKEE

State

Zip

53597

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006