EMILY G FANCIULLO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048315

License Status

EXPIRED

Business

First Name

EMILY

Middle

Last Name

FANCIULLO

Business Name

EMILY G FANCIULLO

Original Issue Date

07/01/2004

Effective Date

07/01/2004

Expiration Date

06/30/2007

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

07/03/2007