JERRY M ANTONINI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036108331

License Status

ACTIVE

Business

Title

First Name

JERRY

Middle

Last Name

ANTONINI

Business Name

JERRY M ANTONINI MD

Original Issue Date

12/20/2002

Effective Date

06/04/2023

Expiration Date

07/31/2026

City

NORMAL

State

Zip

61790

County

MCLEAN

Ever Disciplined

LastModifiedDate

06/04/2023