ALICIA GABRIELA FACCA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****29

License Status

NOT RENEWED

Business

First Name

ALICIA

Middle

GABRIELA

Last Name

FACCA

Suffix

Business Name

ALICIA GABRIELA FACCA MD

Original Issue Date

09/27/2000

Effective Date

09/27/2000

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011