GINA TERESE CIACCIA DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055955

License Status

CANCELLED

Business

Title

First Name

GINA

Middle

TERESE

Last Name

CIACCIA

Business Name

GINA TERESE CIACCIA DO

Original Issue Date

07/01/2009

Effective Date

07/01/2009

Expiration Date

06/30/2012

City

CHICAGO

State

Zip

60616

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

04/28/2009