ANDREA SCIAMMARELLA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048534

License Status

CANCELLED

Business

First Name

ANDREA

Last Name

SCIAMMARELLA

Suffix

Business Name

ANDREA SCIAMMARELLA MD

Original Issue Date

07/01/2004

Effective Date

07/01/2004

Expiration Date

01/12/2009

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006