MICHAEL DOMINICK DIODATO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****08

License Status

ACTIVE

Business

Title

First Name

MICHAEL

Middle

DOMINICK

Last Name

DIODATO

Business Name

MICHAEL DOMINICK DIODATO MD

Original Issue Date

09/15/2009

Effective Date

07/27/2023

Expiration Date

07/31/2026

City

GILBERT

State

Zip

85233

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2023