ORLANDO J ICAZA JR Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125032991

License Status

EXPIRED

Business

First Name

ORLANDO

Middle

Last Name

ICAZA JR

Business Name

ORLANDO J ICAZA JR

Original Issue Date

06/03/1995

Effective Date

06/03/1995

Expiration Date

06/30/2000

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/22/2006