ANTHONY C VACCA DO

Business Entity
ACTIVE

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****71

ACTIVE

N

ANTHONY

C

VACCA

DO

ANTHONY C VACCA DO

03/07/2002

06/04/2023

07/31/2026

MOUNT VERNON

IL

62864

JEFFERSON

II III IV V

N

06/04/2023