MARYLENE VITIELLO Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****93

License Status

ACTIVE

Business

First Name

MARYLENE

Last Name

VITIELLO

Business Name

MARYLENE VITIELLO

Original Issue Date

10/02/1986

Effective Date

05/14/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60615

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/14/2024