MARC D SQUILLANTE DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****23

License Status

ACTIVE

Business

First Name

MARC D

Last Name

SQUILLANTE

Suffix

Business Name

MARC D SQUILLANTE DO

Original Issue Date

06/10/1982

Effective Date

07/12/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61637

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/12/2023