DAVID E CICCOLELLA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036082804

License Status

NOT RENEWED

Business

First Name

DAVID E

Last Name

CICCOLELLA

Suffix

Business Name

DAVID E CICCOLELLA MD

Original Issue Date

07/01/1991

Effective Date

07/01/1991

Expiration Date

07/31/1996

City

CHICAGO

State

Zip

60610

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006