JONATHAN JOSEPH VITALE DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125060172

License Status

CANCELLED

Business

Title

First Name

JONATHAN

Middle

JOSEPH

Last Name

VITALE

Business Name

JONATHAN JOSEPH VITALE DO

Original Issue Date

07/01/2011

Effective Date

07/01/2011

Expiration Date

06/30/2014

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

06/14/2011