DANIEL L ICENOGLE MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036067917

License Status

INACTIVE

Business

First Name

DANIEL

Middle

Last Name

ICENOGLE

Suffix

Business Name

DANIEL L ICENOGLE MD

Original Issue Date

11/07/1983

Effective Date

11/07/1983

Expiration Date

07/31/1987

City

READSTOWN

State

Zip

54652

County

WISCONSIN

Ever Disciplined

LastModifiedDate

03/27/2007

Case Number

1991003556

Action

Reprimand

Discipline Start Date

07/01/1993

Discipline Reason

Disciplined in Wisconsin.