GINA TERESE CIACCIA DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****16

License Status

ACTIVE

Business

Title

First Name

GINA

Middle

TERESE

Last Name

CIACCIA

Business Name

GINA TERESE CIACCIA DO

Original Issue Date

08/01/2011

Effective Date

05/19/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/19/2023