VINCENT JOHN STASCHIAK DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****69

License Status

NOT RENEWED

Business

Title

DPM

First Name

VINCENT

Middle

JOHN

Last Name

STASCHIAK

Business Name

VINCENT JOHN STASCHIAK DPM

Original Issue Date

09/21/2005

Effective Date

09/21/2005

Expiration Date

01/31/2007

City

CHICAGO

State

Zip

60641

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/16/2007