DOMENICO ASCENZIO JOHN FARINA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

ACTIVE

Business

Title

First Name

DOMENICO

Middle

ASCENZIO JOHN

Last Name

FARINA

Business Name

DOMENICO ASCENZIO JOHN FARINA MD

Original Issue Date

04/29/2022

Effective Date

05/30/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/30/2023