CARL P MATTIODA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****73

License Status

NOT RENEWED

Business

First Name

CARL P

Last Name

MATTIODA

Suffix

Business Name

CARL P MATTIODA MD

Original Issue Date

01/01/1997

Effective Date

06/24/2014

Expiration Date

07/31/2017

City

STREATOR

State

Zip

61364

County

LA SALLE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017