CARL A BUCCELLATO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****43

License Status

ACTIVE

Business

First Name

CARL A

Last Name

BUCCELLATO

Business Name

CARL A BUCCELLATO

Original Issue Date

11/13/1997

Effective Date

05/04/2023

Expiration Date

07/31/2026

City

VERNON HILLS

State

Zip

60061

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/04/2023