TONY ALBERT FANTOZZI - Physician Assistant License in Illinois | # 085002329

TONY ALBERT FANTOZZI

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002329

License Status

INACTIVE

Business

N

First Name

TONY

Middle

ALBERT

Last Name

FANTOZZI

Business Name

TONY ALBERT FANTOZZI

Original Issue Date

09/10/2004

Effective Date

09/10/2004

Expiration Date

03/01/2006

State

IL

Ever Disciplined

N

LastModifiedDate

10/09/2006