PIERO M A FISICHELLA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****68

License Status

NOT RENEWED

Business

First Name

PIERO

Middle

M A

Last Name

FISICHELLA

Suffix

Business Name

PIERO M A FISICHELLA MD

Original Issue Date

09/22/2004

Effective Date

05/18/2020

Expiration Date

07/31/2023

City

ELGIN

State

Zip

60124

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023