EUGENE A BROCCOLO MD Medical Corporation License verification

Business Entity

NOT RENEWED

License Type

Medical Corporation

Description

REGISTERED MEDICAL CORPORATION

License Number

042001906

License Status

NOT RENEWED

Business

Business Name

EUGENE A BROCCOLO MD

Original Issue Date

09/14/1973

Effective Date

09/14/1973

Expiration Date

01/01/1989

City

PARK RIDGE

State

Zip

60068

County

COOK

Ever Disciplined

LastModifiedDate

09/26/2006