CASEY DISTASO MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125072192

License Status

EXPIRED

Business

Title

First Name

CASEY

Last Name

DISTASO

Business Name

CASEY DISTASO MD

Original Issue Date

06/24/2018

Effective Date

06/24/2018

Expiration Date

06/23/2021

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

10/11/2022