DIANA FRANCES BONACCORSI DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125068888

License Status

CANCELLED

Business

Title

First Name

DIANA

Middle

FRANCES

Last Name

BONACCORSI

Business Name

DIANA FRANCES BONACCORSI DO

Original Issue Date

06/25/2016

Effective Date

06/25/2016

Expiration Date

06/24/2018

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/31/2016