CHARLES A AMENTA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****40

License Status

NOT RENEWED

Business

First Name

CHARLES A

Last Name

AMENTA

Suffix

Business Name

CHARLES A AMENTA MD

Original Issue Date

09/06/1996

Effective Date

09/06/1996

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60629

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020