KRISTIN NICOLE VERCILLO MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057837

License Status

CANCELLED

Business

Title

First Name

KRISTIN

Middle

NICOLE

Last Name

VERCILLO

Business Name

KRISTIN NICOLE VERCILLO MD

Original Issue Date

07/01/2013

Effective Date

07/01/2013

Expiration Date

06/30/2015

City

LIBERTYVILLE

State

Zip

60048

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

03/24/2014