DOMINIC A ANTICO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

NOT RENEWED

Business

First Name

DOMINIC A

Last Name

ANTICO

Suffix

Business Name

DOMINIC A ANTICO MD

Original Issue Date

11/23/1992

Effective Date

11/23/1992

Expiration Date

07/31/1993

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

09/26/2006