ANTOINE GERGI DACCACHE Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125046985

License Status

EXPIRED

Business

First Name

ANTOINE

Middle

GERGI

Last Name

DACCACHE

Business Name

ANTOINE GERGI DACCACHE

Original Issue Date

07/08/2003

Effective Date

07/08/2003

Expiration Date

07/07/2006

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006