MICHAEL DOMINIC TARANTINO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****29

License Status

ACTIVE

Business

First Name

MICHAEL

Middle

DOMINIC

Last Name

TARANTINO

Suffix

Business Name

MICHAEL DOMINIC TARANTINO MD

Original Issue Date

09/23/1999

Effective Date

06/07/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/07/2023