VICTOR DOMINIC ANTONACCI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

NOT RENEWED

Business

First Name

VICTOR

Middle

DOMINIC

Last Name

ANTONACCI

Suffix

Business Name

VICTOR DOMINIC ANTONACCI MD

Original Issue Date

07/02/2013

Effective Date

09/30/2020

Expiration Date

07/31/2023

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023