DANIEL P VICENCIO MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125027729

License Status

EXPIRED

Business

First Name

DANIEL P

Last Name

VICENCIO

Suffix

Business Name

DANIEL P VICENCIO MD

Original Issue Date

04/24/1992

Effective Date

04/24/1992

Expiration Date

06/22/1995

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006