GIACOMO COLVER WALLER MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125077143

License Status

EXPIRED

Business

Title

First Name

GIACOMO

Middle

COLVER

Last Name

WALLER

Business Name

GIACOMO COLVER WALLER MD

Original Issue Date

06/22/2020

Effective Date

06/22/2020

Expiration Date

06/21/2023

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

03/06/2024