JERRY M ANTONINI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****66

License Status

ACTIVE

Business

Title

First Name

JERRY

Middle

Last Name

ANTONINI

Business Name

JERRY M ANTONINI MD

Original Issue Date

02/27/2003

Effective Date

06/04/2023

Expiration Date

07/31/2026

City

NORMAL

State

Zip

61790

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/04/2023