MARK T DONVITO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036077356

License Status

ACTIVE

Business

First Name

MARK T

Last Name

DONVITO

Suffix

Business Name

MARK T DONVITO MD

Original Issue Date

07/16/1988

Effective Date

05/19/2023

Expiration Date

07/31/2026

City

CARBONDALE

State

Zip

62902

County

JACKSON

Ever Disciplined

LastModifiedDate

05/19/2023