BRIAN D VACCA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125046356

License Status

EXPIRED

Business

First Name

BRIAN

Middle

Last Name

VACCA

Business Name

BRIAN D VACCA

Original Issue Date

06/23/2003

Effective Date

06/23/2003

Expiration Date

06/30/2007

City

MAYWOOD

State

Zip

60153

County

COOK

Ever Disciplined

LastModifiedDate

07/03/2007