PAVEL ANTONOV MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****18

License Status

NOT RENEWED

Business

Title

First Name

PAVEL

Last Name

ANTONOV

Business Name

PAVEL ANTONOV MD

Original Issue Date

11/13/2020

Effective Date

11/13/2020

Expiration Date

07/31/2023

City

PARIS

State

Zip

61944

County

EDGAR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023