AMANDA MARIE FICACELLI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****92

License Status

NOT RENEWED

Business

Title

First Name

AMANDA

Middle

MARIE

Last Name

FICACELLI

Business Name

AMANDA MARIE FICACELLI MD

Original Issue Date

06/24/2010

Effective Date

06/13/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60614

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014