GUSTAVO MIGUEL BANTI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****15

License Status

NOT RENEWED

Business

First Name

GUSTAVO MIGUEL

Last Name

BANTI

Suffix

Business Name

GUSTAVO MIGUEL BANTI MD

Original Issue Date

07/19/1990

Effective Date

07/19/1990

Expiration Date

07/31/1993

City

ST CHARLES

State

Zip

60174

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011