ANTHONY MATTIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****82

License Status

NOT RENEWED

Business

First Name

ANTHONY

Last Name

MATTIS

Suffix

Business Name

ANTHONY MATTIS MD

Original Issue Date

07/25/1994

Effective Date

07/25/1994

Expiration Date

07/31/1996

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006