DOMINIC JOSEPH ANTONACCI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****27

License Status

ACTIVE

Business

Title

First Name

DOMINIC

Middle

JOSEPH

Last Name

ANTONACCI

Business Name

DOMINIC JOSEPH ANTONACCI MD

Original Issue Date

01/30/2024

Effective Date

01/30/2024

Expiration Date

07/31/2026

City

EVANSTON

State

Zip

60202

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/30/2024