MICHAEL ANTHONY ACQUAVIVA MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036119149

License Status

INACTIVE

Business

First Name

MICHAEL

Middle

ANTHONY

Last Name

ACQUAVIVA

Suffix

Business Name

MICHAEL ANTHONY ACQUAVIVA MD

Original Issue Date

08/07/2007

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

WOODRIDGE

State

Zip

60517

County

DUPAGE

Ever Disciplined

LastModifiedDate

04/07/2011