MARK L VITALE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****83

License Status

NOT RENEWED

Business

First Name

MARK L

Last Name

VITALE

Business Name

MARK L VITALE

Original Issue Date

08/08/1988

Effective Date

08/30/2018

Expiration Date

01/31/2022

City

LOMBARD

State

Zip

60148

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022