LEONARD J BUCCELLATO - Medical Doctor License in Illinois | # 125037963

LEONARD J BUCCELLATO

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125037963

License Status

EXPIRED

Business

N

First Name

LEONARD

Middle

J

Last Name

BUCCELLATO

Business Name

LEONARD J BUCCELLATO

Original Issue Date

05/26/1998

Effective Date

05/26/1998

Expiration Date

06/15/2001

State

IL

Specialty/Qualifier

Internal Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006