JULIAN ANTONY MATTIELLO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****85

License Status

NOT RENEWED

Business

Title

First Name

JULIAN

Middle

ANTONY

Last Name

MATTIELLO

Business Name

JULIAN ANTONY MATTIELLO MD

Original Issue Date

08/03/2005

Effective Date

05/20/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011