ELSY ANTONY DEVASSY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

ACTIVE

Business

First Name

ELSY ANTONY

Last Name

DEVASSY

Suffix

Business Name

ELSY ANTONY DEVASSY MD

Original Issue Date

08/15/1990

Effective Date

06/26/2023

Expiration Date

07/31/2026

City

LOCKPORT

State

Zip

60441

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/26/2023