WILLIAM FREDERICK BEVILACQUA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****62

License Status

NOT RENEWED

Business

Title

First Name

WILLIAM

Middle

FREDERICK

Last Name

BEVILACQUA

Business Name

WILLIAM FREDERICK BEVILACQUA MD

Original Issue Date

05/13/2014

Effective Date

05/13/2014

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