ETTORE DI MICELI MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****34

License Status

CANCELLED

Business

First Name

ETTORE

Last Name

DI MICELI

Suffix

Business Name

ETTORE DI MICELI MD

Original Issue Date

10/26/1983

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011