ANTHONY ROCCO FASANELLA DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125042562

License Status

EXPIRED

Business

First Name

ANTHONY

Middle

ROCCO

Last Name

FASANELLA

Suffix

Business Name

ANTHONY ROCCO FASANELLA DO

Original Issue Date

07/01/2001

Effective Date

07/01/2001

Expiration Date

06/30/2004

City

CHICAGO

State

Zip

60631

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

09/22/2006