JILL MARIE ANTONIAZZI 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

JILL

Middle

MARIE

Last Name

ANTONIAZZI

Suffix

Business Name

JILL MARIE ANTONIAZZI MD

Original Issue Date

08/02/2005

Effective Date

08/02/2005

Expiration Date

07/31/2008

City

BERWYN

State

Zip

60402

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017