ERICH N MUSSAK MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055115

License Status

CANCELLED

Business

Title

First Name

ERICH

Middle

Last Name

MUSSAK

Business Name

ERICH N MUSSAK MD

Original Issue Date

07/01/2008

Effective Date

07/01/2008

Expiration Date

06/30/2011

City

FOX POINT

State

Zip

53217

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

05/28/2008