ALEXANDRA I B INCANDELA DPM Podiatrist License verification

Business Entity

CANCELLED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135001068

License Status

CANCELLED

Business

Title

DPM

First Name

ALEXANDRA

Middle

I B

Last Name

INCANDELA

Business Name

ALEXANDRA I B INCANDELA DPM

Original Issue Date

08/22/2019

Effective Date

08/22/2019

Expiration Date

08/22/2022

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

08/02/2019