BRUNO VINCENT DECARIA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056820

License Status

CANCELLED

Business

Title

First Name

BRUNO

Middle

VINCENT

Last Name

DECARIA

Business Name

BRUNO VINCENT DECARIA MD

Original Issue Date

06/23/2012

Effective Date

06/23/2012

Expiration Date

06/22/2013

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

04/05/2012