LUIS FERNANDO GONZALEZ CICCARELLI MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071005

License Status

EXPIRED

Business

Title

First Name

LUIS

Middle

FERNANDO

Last Name

GONZALEZ CICCARELLI

Business Name

LUIS FERNANDO GONZALEZ CICCARELLI MD

Original Issue Date

06/24/2018

Effective Date

06/24/2018

Expiration Date

06/23/2019

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

10/02/2019