ROBERT D MATTEUCCI DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****87

License Status

NOT RENEWED

Business

First Name

ROBERT

Middle

Last Name

MATTEUCCI

Suffix

DPM

Business Name

ROBERT D MATTEUCCI DPM

Original Issue Date

03/19/2004

Effective Date

06/29/2009

Expiration Date

01/31/2011

City

ROUND LAKE BEACH

State

Zip

60073

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/10/2011