MARK ETTORE GIACOMI DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125054675

License Status

CANCELLED

Business

Title

First Name

MARK

Middle

ETTORE

Last Name

GIACOMI

Business Name

MARK ETTORE GIACOMI DO

Original Issue Date

06/30/2008

Effective Date

06/30/2008

Expiration Date

06/29/2011

City

PLAINFIELD

State

Zip

60544

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/12/2008