IAN ANTHONY CONCILIO 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

IAN

Middle

ANTHONY

Last Name

CONCILIO

Suffix

Business Name

IAN ANTHONY CONCILIO MD

Original Issue Date

07/06/2000

Effective Date

07/06/2000

Expiration Date

07/31/2005

City

CARBONDALE

State

Zip

62901

County

JACKSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006