EVELYN J ICASIANO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****15

License Status

NOT RENEWED

Business

First Name

EVELYN

Middle

Last Name

ICASIANO

Suffix

Business Name

EVELYN J ICASIANO MD

Original Issue Date

05/22/2006

Effective Date

05/22/2006

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008