MARY E CIANFROCCA DO Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036086852

License Status

INACTIVE

Business

First Name

MARY

Middle

Last Name

CIANFROCCA

Suffix

Business Name

MARY E CIANFROCCA DO

Original Issue Date

07/19/1993

Effective Date

07/02/2008

Expiration Date

07/31/2011

City

MESA

State

Zip

85207

Ever Disciplined

LastModifiedDate

02/06/2012

Case Number

2011006686

Action

Suspension

Discipline Start Date

10/14/2011

Discipline End Date

12/06/2011

Discipline Reason

Failure to file and/or pay Illinois state income taxes. Notice of tax deficiency release received from Department of Revenue on 12/07/2011.