CHARLES ANTHONY CAVALLO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****43

License Status

NOT RENEWED

Business

First Name

CHARLES ANTHONY

Last Name

CAVALLO

Suffix

Business Name

CHARLES ANTHONY CAVALLO MD

Original Issue Date

01/01/1997

Effective Date

08/22/2017

Expiration Date

09/30/2020

City

ST CHARLES

State

Zip

60174

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021