ANDREW JAMES CUSACK DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

ACTIVE

Business

Title

First Name

ANDREW

Middle

JAMES

Last Name

CUSACK

Business Name

ANDREW JAMES CUSACK DO

Original Issue Date

04/24/2015

Effective Date

06/16/2023

Expiration Date

07/31/2026

City

DUNLAP

State

Zip

61525

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/16/2023