License holder summary

CAROL ANTONSEN KOOISTRA is a Medical Physician And Surgeon licensed to practice in Pennsylvania. The address on file for CAROL ANTONSEN KOOISTRA is Lynn NC 28750. This medical practitioner license is not current. The license was granted 10/20/2004 and expired on 12/31/2006.

Department of State

Board of Medicine

CAROL ANTONSEN KOOISTRA
Medical Physician And Surgeon
License number
MD425389
Date granted
10/20/2004
Date expires
12/31/2006
Class
Medical Physician And Surgeon
Status
Surrendered
Address
Lynn NC 28750
medicinepa.com
ID 37632901
LAST UPDATED 2026-03-25 15:51:18 UTC

This website is unaffiliated with the Board of Medicine. Please verify all information directly with the relevant official government authority.

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