EVELYN J ICASIANO MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048348

License Status

EXPIRED

Business

First Name

EVELYN

Middle

Last Name

ICASIANO

Suffix

Business Name

EVELYN J ICASIANO MD

Original Issue Date

07/01/2004

Effective Date

07/01/2004

Expiration Date

06/30/2007

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Ophthalmology

Ever Disciplined

LastModifiedDate

07/03/2007