PIERO M A FISICHELLA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045153

License Status

CANCELLED

Business

First Name

PIERO

Middle

M A

Last Name

FISICHELLA

Suffix

Business Name

PIERO M A FISICHELLA MD

Original Issue Date

06/24/2002

Effective Date

06/24/2002

Expiration Date

06/23/2005

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/22/2006