PETRONILO R COSTA MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****71

NOT RENEWED

N

MD

PETRONILO

R

COSTA

PETRONILO R COSTA MD

01/01/1997

07/24/2020

07/31/2023

DEERFIELD

IL

60015

LAKE

PRACTITIONER

II III IV V

N

11/30/2023