PHILLIP MICHAEL PORCELLI DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055512

License Status

EXPIRED

Business

Title

First Name

PHILLIP

Middle

MICHAEL

Last Name

PORCELLI

Business Name

PHILLIP MICHAEL PORCELLI DO

Original Issue Date

07/08/2008

Effective Date

07/08/2008

Expiration Date

07/07/2011

City

NORMAL

State

Zip

61761

County

MCLEAN

Specialty/Qualifier

Neurological Surgery

Ever Disciplined

LastModifiedDate

09/30/2011