EMILY G FANCIULLO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036116845

License Status

NOT RENEWED

Business

First Name

EMILY

Middle

Last Name

FANCIULLO

Business Name

EMILY G FANCIULLO

Original Issue Date

08/30/2006

Effective Date

05/28/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60607

County

COOK

Ever Disciplined

LastModifiedDate

11/14/2011