JASPER ANTONIO CARMINE PETRUCCI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****47

License Status

ACTIVE

Business

Title

First Name

JASPER

Middle

ANTONIO CARMINE

Last Name

PETRUCCI

Business Name

JASPER ANTONIO CARMINE PETRUCCI MD

Original Issue Date

06/18/2003

Effective Date

07/20/2023

Expiration Date

07/31/2026

City

ELGIN

State

Zip

60123

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/20/2023