MARCONI D DELADISMA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047037

License Status

EXPIRED

Business

Title

First Name

MARCONI

Middle

Last Name

DELADISMA

Business Name

MARCONI D DELADISMA MD

Original Issue Date

07/18/2003

Effective Date

07/18/2003

Expiration Date

07/17/2006

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006