CHARLES J DICECCO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036062120

License Status

NOT RENEWED

Business

First Name

CHARLES J

Last Name

DICECCO

Suffix

Business Name

CHARLES J DICECCO MD

Original Issue Date

05/13/1981

Effective Date

05/13/1981

Expiration Date

07/31/1996

City

ALTON

State

Zip

62002

County

MADISON

Ever Disciplined

LastModifiedDate

09/20/2006