ANTHONY JOHN VITA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045182

License Status

CANCELLED

Business

First Name

ANTHONY

Middle

JOHN

Last Name

VITA

Suffix

Business Name

ANTHONY JOHN VITA MD

Original Issue Date

07/01/2002

Effective Date

07/01/2002

Expiration Date

06/30/2004

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Preventive Medicine

Ever Disciplined

LastModifiedDate

09/22/2006