MARIO G MASSULLO DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125022482

License Status

EXPIRED

Business

First Name

MARIO G

Last Name

MASSULLO

Suffix

Business Name

MARIO G MASSULLO DO

Original Issue Date

05/21/1988

Effective Date

05/21/1988

Expiration Date

07/01/1991

City

CHICAGO

State

Zip

60615

County

COOK

Specialty/Qualifier

Family Practice & OMT

Ever Disciplined

LastModifiedDate

09/22/2006