EVELYN J ICASIANO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036115650

License Status

NOT RENEWED

Business

First Name

EVELYN

Middle

Last Name

ICASIANO

Suffix

Business Name

EVELYN J ICASIANO MD

Original Issue Date

04/07/2006

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

UNION CITY

State

Zip

07087

Ever Disciplined

LastModifiedDate

11/06/2008