ANTONIO M CRISOSTOMO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****54

License Status

NOT RENEWED

Business

First Name

ANTONIO M

Last Name

CRISOSTOMO

Suffix

Business Name

ANTONIO M CRISOSTOMO MD

Original Issue Date

08/12/1993

Effective Date

06/09/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60651

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017