MATTHEW DEAN MASCIOLI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****55

License Status

NOT RENEWED

Business

First Name

MATTHEW

Middle

DEAN

Last Name

MASCIOLI

Suffix

Business Name

MATTHEW DEAN MASCIOLI MD

Original Issue Date

04/14/2016

Effective Date

04/14/2016

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017