IVAN ANTOSH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****41

License Status

ACTIVE

Business

Title

First Name

IVAN

Last Name

ANTOSH

Business Name

IVAN ANTOSH MD

Original Issue Date

12/08/2022

Effective Date

06/01/2023

Expiration Date

07/31/2026

City

FORT SAM HOUSTON

State

Zip

78234

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/01/2023