VICTOR DOMINIC ANTONACCI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****32

License Status

NOT RENEWED

Business

First Name

VICTOR

Middle

DOMINIC

Last Name

ANTONACCI

Suffix

Business Name

VICTOR DOMINIC ANTONACCI MD

Original Issue Date

01/14/2002

Effective Date

04/22/2014

Expiration Date

07/31/2017

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020