MICHAEL MERCANDETTI MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****51

License Status

INACTIVE

Business

First Name

MICHAEL

Last Name

MERCANDETTI

Suffix

Business Name

MICHAEL MERCANDETTI MD

Original Issue Date

04/11/2019

Effective Date

09/14/2020

Expiration Date

07/31/2023

City

PEORIA

State

Zip

61615

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/04/2023