MARY ELLEN WALTON CONTI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036050872

License Status

NOT RENEWED

Business

Title

First Name

MARY ELLEN

Middle

WALTON

Last Name

CONTI

Business Name

MARY ELLEN WALTON CONTI MD

Original Issue Date

03/21/1975

Effective Date

07/19/2017

Expiration Date

09/30/2020

City

ALTON

State

Zip

62002

County

MADISON

Ever Disciplined

LastModifiedDate

01/14/2021