SALVATORE J BIAZZO DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036092688

License Status

NOT RENEWED

Business

First Name

SALVATORE J

Last Name

BIAZZO

Suffix

Business Name

SALVATORE J BIAZZO DO

Original Issue Date

05/21/1996

Effective Date

05/21/1996

Expiration Date

07/31/2005

City

ROCKFORD

State

Zip

61109

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/09/2006