ANTHONY J BONIELLO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

NOT RENEWED

Business

Title

First Name

ANTHONY

Middle

Last Name

BONIELLO

Business Name

ANTHONY J BONIELLO MD

Original Issue Date

03/05/2020

Effective Date

09/16/2020

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60612

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023