DAVID M SQUICQUERO 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

First Name

DAVID M

Last Name

SQUICQUERO

Suffix

Business Name

DAVID M SQUICQUERO MD

Original Issue Date

02/11/1993

Effective Date

02/11/1993

Expiration Date

07/31/1996

City

COLLINSVILLE

State

Zip

62234

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006