JOHN CHARLES DEPETRILLO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****79

License Status

NOT RENEWED

Business

Title

First Name

JOHN

Middle

CHARLES

Last Name

DEPETRILLO

Business Name

JOHN CHARLES DEPETRILLO MD

Original Issue Date

03/04/2013

Effective Date

06/06/2014

Expiration Date

07/31/2017

City

SAINT LOUIS

State

Zip

63141

County

MISSOURI

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017