NICCOLO EMANUELE MENCACCI MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125075171

License Status

CANCELLED

Business

Title

First Name

NICCOLO

Middle

EMANUELE

Last Name

MENCACCI

Business Name

NICCOLO EMANUELE MENCACCI MD

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2021

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Neurology Movement Disorder

Ever Disciplined

LastModifiedDate

06/20/2019