DENNIS JAMES COSTA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****93

License Status

ACTIVE

Business

Title

First Name

DENNIS

Middle

JAMES

Last Name

COSTA

Business Name

DENNIS JAMES COSTA MD

Original Issue Date

10/02/2025

Effective Date

10/02/2025

Expiration Date

07/31/2026

City

CHAMPAIGN

State

Zip

61820

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/02/2025