KELLY AMBER VITALE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036156544

License Status

NOT RENEWED

Business

Title

First Name

KELLY

Middle

AMBER

Last Name

VITALE

Business Name

KELLY AMBER VITALE MD

Original Issue Date

04/14/2021

Effective Date

04/14/2021

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

11/30/2023