GLEN LEE RICCA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036060768

License Status

NOT RENEWED

Business

First Name

GLEN

Middle

LEE

Last Name

RICCA

Suffix

Business Name

GLEN LEE RICCA MD

Original Issue Date

08/13/1980

Effective Date

03/01/2021

Expiration Date

05/31/2021

City

STREATOR

State

Zip

61364

County

LA SALLE

Ever Disciplined

LastModifiedDate

02/15/2023