AMANDA MARIE FICACELLI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036125681

License Status

NOT RENEWED

Business

Title

First Name

AMANDA

Middle

MARIE

Last Name

FICACELLI

Business Name

AMANDA MARIE FICACELLI MD

Original Issue Date

05/05/2010

Effective Date

05/23/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60654

County

COOK

Ever Disciplined

LastModifiedDate

11/17/2014