PHYLLIS N BONAMINIO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

ACTIVE

Business

First Name

PHYLLIS

Middle

Last Name

BONAMINIO

Suffix

Business Name

PHYLLIS N BONAMINIO MD

Original Issue Date

08/01/2001

Effective Date

05/09/2023

Expiration Date

07/31/2026

City

PALOS HTS

State

Zip

60463

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2023