MARC A BELLAZZINI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****13

License Status

NOT RENEWED

Business

First Name

MARC

Middle

Last Name

BELLAZZINI

Suffix

Business Name

MARC A BELLAZZINI MD

Original Issue Date

03/23/2000

Effective Date

03/23/2000

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006