JUAN ANTONIO ACOSTA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****87

License Status

NOT RENEWED

Business

Title

First Name

JUAN

Middle

ANTONIO

Last Name

ACOSTA

Business Name

JUAN ANTONIO ACOSTA MD

Original Issue Date

02/04/2016

Effective Date

02/04/2016

Expiration Date

07/31/2017

City

GRAYSLAKE

State

Zip

60030

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020