DOMINIC JOSEPH ANTONACCI MD - Medical Doctor License in Illinois | # 125071947

DOMINIC JOSEPH ANTONACCI MD

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071947

License Status

CANCELLED

Business

N

Title

MD

First Name

DOMINIC

Middle

JOSEPH

Last Name

ANTONACCI

Business Name

DOMINIC JOSEPH ANTONACCI MD

Original Issue Date

06/26/2021

Effective Date

06/26/2021

Expiration Date

06/25/2023

State

IL

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

N

LastModifiedDate

03/09/2021