DANA S VITALE DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036136675

License Status

NOT RENEWED

Business

Title

First Name

DANA

Middle

Last Name

VITALE

Business Name

DANA S VITALE DO

Original Issue Date

10/15/2014

Effective Date

10/15/2014

Expiration Date

07/31/2017

City

KINGMAN

State

Zip

86401

County

ARIZONA

Ever Disciplined

LastModifiedDate

11/01/2017