DAVID J KLECZEK Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000791

License Status

NOT RENEWED

Business

First Name

DAVID J

Last Name

KLECZEK

Business Name

DAVID J KLECZEK

Original Issue Date

03/27/1996

Effective Date

03/27/1996

Expiration Date

03/01/2000

City

PITTSFIELD

State

Zip

62363

County

PIKE

Ever Disciplined

LastModifiedDate

09/26/2006