ELIA M DISAVINO MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125037658

License Status

EXPIRED

Business

Title

First Name

ELIA

Middle

Last Name

DISAVINO

Business Name

ELIA M DISAVINO MD

Original Issue Date

05/13/1998

Effective Date

05/13/1998

Expiration Date

06/30/2003

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Neurophysiology

Ever Disciplined

LastModifiedDate

09/22/2006