STACY L PANOZZO DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125060895

License Status

CANCELLED

Business

Title

First Name

STACY

Middle

Last Name

PANOZZO

Business Name

STACY L PANOZZO DO

Original Issue Date

06/24/2012

Effective Date

06/24/2012

Expiration Date

06/23/2015

City

MUNDELEIN

State

Zip

60060

County

LAKE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

03/24/2014