ANTHONY J AFFATATO - Medical Doctor License in Illinois | # 125020745

ANTHONY J AFFATATO

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125020745

License Status

EXPIRED

Business

N

First Name

ANTHONY

Middle

J

Last Name

AFFATATO

Business Name

ANTHONY J AFFATATO

Original Issue Date

05/08/1987

Effective Date

05/08/1987

Expiration Date

07/01/1990

State

IL

Specialty/Qualifier

Family Practice & OMT

Ever Disciplined

N

LastModifiedDate

09/22/2006